Tuesday, May 5, 2026

Medicare's 14 Day Rule and 3 Day Rule: Why One is Crazy and the Other Isn't

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 . I learned much about this when I recently asked Chat GPT to write long detailed essays on the history of each rule, 3-day and 14-day .  ...

Congr Comer Asks CMS - Does AMA CPT Complexity Support Fraud?

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 Congr. Comer (KY) writes CMS, raises questions about AMA CPT structure and coding, and fraud and abuse issues. Comer letter here .   Comer ...
Monday, May 4, 2026

Chat GPT Discusses the Serena-6 Trial, ESR1 by LBx, and FDA Advisory Committee ODAC

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Chat GPT summarizes the data on the recently released SERENA-6 trial and ODAC-FDA advisory board.  OncLive here .  Fierce Biotech here .  Pr...
Sunday, May 3, 2026

RFK Blog 02: Chat GPT Assesses the Seven RFK-Hill Transcripts (April 2026)

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  RFK Jr.’s Seven-Hearing Hill Marathon: April 16–22, 2026 Blog 01 - I asked Chat GPT to find all 7 hearings and identify transcripts. Blog...

Chat GPT Writes Complex Memo on Policy History: Twenty Years of Date of Service Rules

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  Memorandum on the Medicare Laboratory Date of Service Rule Executive summary   This memorandum was written by Chat GPT in its “deep ...

RFK Blog 01: Chat GPT Saves Hours: Finding the 7 RFK Jr Hearings

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Blog 01 - HERE - I asked Chat GPT to find all 7 hearings and identify transcripts.  HERE. Zip file of the 7 transcripts at google drive here...
Friday, May 1, 2026

CMS Announces Summer CLFS Pricing Meetings + Special PAMA Pricing Meeting

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CMS has posted dates for its regular summer meetings for new lab code pricing.  In addition, CMS has planned a September two-day meeting for...
Wednesday, April 29, 2026

Can AI Understand Medicare Policy? Can It Explain the Three-Day Rule (for DRG)

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 Can Chat GPT explain gnarly tortuous Medicare policies?   One example is the 3-day-rule.  Services to a patient by a hospital are bundled f...

Chat GPT Explains Its Understanding of Where AMA Appendix S (AI Services) Comes From

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For a year, AMA has been extensively revising its Appendix S, which is guidance for categories and coding of software-intensive services lik...
Sunday, April 26, 2026

Two Articles on the Medicare CRUSH Anti-fraud Effort

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 Much has been written about CRUSH in the past month, here are two more. American Journal of Managed Care covers Medicare fraud hearings.  F...
Friday, April 24, 2026

Six Powerful Ways AI Helped Me Understand AMA CPT AI Policy (Appendix S)

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  How AI Has Greatly Helped Me Understand AMA CPT “APPENDIX S” For AI   For over a year, AMA has been working on a heavy overhaul of its A...
Thursday, April 23, 2026

Chat GPT Assessing an Important Court Case for Labs on Medical Necessity

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For years, labs have had variable success during audits (or during prior authorization), depending on how much original physician-side chart...

Amazing: AI Can CLean-Up the "APPENDIX S" AI Policy for AMA CPT Meeting

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Several years ago, AMA CPT introduced "Appendix S," a policy statement about language and coding for software-intensive services. ...

CMS Announces "RAPID" Coverage for Breakthrough Devices - More to Follow

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CMS Announces RAPID Pathway for Breakthrough Devices;  "Cuts Red Tape" On April 23, CMS issued a press release annoucing a new CM...
Wednesday, April 22, 2026

Connecting the Dots is Fun: From FOCR Webinar to WSJ FDA Article

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  It’s always interesting when policy dots connect across events that at first seem unrelated. A few weeks ago, Friends of Cancer Research ...