Wednesday, July 29, 2026

Very Brief Blog: New Book Coming: Pixels and Precision Pathology

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 It's not out yet, but I'm seeing publicity for a new book on computational pathology, "Precision Pathology: From Pixels to Pr...
Tuesday, July 28, 2026

AI Corner: AI Counts New Diagnostic LCDs, Timelines

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I was interested in how many LCDs the different MACs produce for lab diagnostics (MolDx, Novitas, Wellpoint Federal [former NGS MAC].) To my...

Nerd Note: How CMS Handles Initial OPPS Pricing of the Newest Cat III Codes

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In the previous blog , I noted that CMS provides proposed OPPS/APC prices of Cat III codes that won't be effective for six months...and ...

AMA Releases Cat III Codes; CMS Prices New Digital Pathology Cat III Codes

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 A lot of action on the digital pathology front. #1 AMA RELEASES Dig Path CODES After the equivalent of a moratorium on new digital patholog...
Monday, July 27, 2026

Excellent Movie May Contain Medicare Policy Error

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 I live in Hollywood; I love movies.   I've worked on CMS policy for twenty years; I love CMS policy. Here's a potential glitch wher...

Two Articles by Lennerz: (1) Fixing European IVD Regs, (2) Flexible & Agile Regulation

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 One of the most reliably interesting voices on Linked In is Joe Lennerz, successively of Harvard, Boston Gene, and now Natera.  Find his ho...
Sunday, July 26, 2026

WSJ Opinion Piece: "Trump's Plan to Reform the AMA"

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On July 14, the Washington Post had a scoop as the physician payment rule was released: it would contain an abrasive RFI going after AMA for...

Very Brief Blog: Hospital Charges In Real Life: $15,417 for $446

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 I had an MRI in June at a nearby hospital outpatient center.   When I log onto Medicare.gov/my/claims, I see the MRI code the hospital cha...
Friday, July 24, 2026

How I Use AI: What Percent of CRC Stool-test Orders Get Done? What Percent of Positives Get Colonoscopy?

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Header:  Chat GPT rapidly answers general medical questions, here, slippage in colon cancer screening. ## We had a screening colonoscopy in ...
Thursday, July 23, 2026

More CMS Legal Cases: LCD Challenges

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 Header: A dissatisfied beneficiary can appeal his denied claim, OR, challenge the offending NCD or LCD as a whole. Let's see what's...

MolDx in Court: Scanning CMS and Federal Cases for "MolDx"

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 I'm such a CMS nerd that every year or two I used to scan the CMS Office of Hearings and Appeals (OMHA) for interesting cases.  (Back-w...

From NGS MAC to WELLPOINT FEDERAL

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I mentioned several weeks ago that the NGS MAC (New England, New York, and MN-WI-IL) had begun referring to itself as WELLPOINT FEDERAL.  (W...

CMS and Software-Intensive Lab Services: The Third Rail is "How to Enroll" after Coding and Payment

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In both its OPPS proposed rules, and its PFS or Part B proposed rules, CMS has proposed to drop AI-based or software-intensive lab diagnosti...
Wednesday, July 22, 2026

Very Brief Blog: FDA Guidance on Payor Communications

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Here's one for your horizon scan.  FDA has posted draft guidance updating its policies for communications with payors, such as HEOR info...
Tuesday, July 21, 2026

Here's the AI White Paper on Paying for AI...Articles from STAT and PETERSON

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Do payers pay for AI?   Or do they assume AI-mediated savings, and deflation of prices?  Is one clinical area totally different from another...