Tuesday, June 16, 2026

Breaking News: Noridian to Hold Meeting on Neurodegenerative Diagnostic Lab Tests

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There's been a boom in more accurate lab tests in neurodegenerative disease - both Alzheimer's and Parkinson's - and quite a f...

87798: OIG Going After Use of "Panels" Larger than 5 Assays

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The MolDx program, and perhaps others, have LCDs making it difficult (not impossible) to bill for covered pathogen panels of >5 pathogens...
Monday, June 15, 2026

Nerd Note: What's Up with Medicaid Waivers, Statute 1115, New Neutrality Rule (1115(g))

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I've been perpetually confused by SSA 1115 Medicaid waivers , and SSA 1115A which creates the CMMI, Center for Medicare Innovation.   ...
Sunday, June 14, 2026

Sidebar: Urologist Billing of 87798

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The 30 MolDx states have LCDs that generally, make it hard to bill for panels of  >5  pathogens (with some rules and exceptions), and th...

Medicare Labs Intensely Billing 87798: Comparing Novitas/Texas and Noridian/California

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See a June 2026 article on sentencing of a Burbank lab fraud case in the tens of millions of dollars.  And now in 2026, we're hearing a...

CMS Creates New "Office of Health Technology & Health Technology Products" - Led by Amy Gleason

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  It's a quiet Thursday, you're reading the new issue of Federal Register, not to much too see, turn the page, turn the page again.....
Friday, June 12, 2026

The Fascinating Context: Florida's Dr. Dunn, HR 8500 (LCDs), HR8890 (CLIA)

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 [AI Corner, Chat GPT] See also: Blog on HR 8500, LCD Reform, here     Cosponsor: Barragan (D-CA), Tenney (R-NY) See also: Blog on HR 8890, ...

Digital Pathology at CMS: Annual Lab Meeting Postpones It, But CLIA Reform Would Boost It

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 If you follow digital pathology (whole slide imaging) at CMS, you'll know that Medicare placed around ten WSI tests on the Clinical La...

Congress Releases Full Text of 45-page CLIA Reform Bill

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In May 2026, Congressman Dunn of Florida issued a press release about a new Enhance CLIA bill ( here ), and there was a policy article from ...

HHS OIG Releases Legal Viewpoint on MCED Supplemental Testing

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 A favorite question the last five or ten years - if CMS pays you for one test (let's say CRC screening) can the lab provide an addition...

AI Guest Report: Claude Opus Reviews Annual Lab Meeting (June 10, 2026)

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On June 10, 2026, CMS held its all-day Annual Lab Meeting for public comment on correct pricing of over 100 new lab test codes. Claude Opus ...
Wednesday, June 10, 2026

AI Guest Column 02: Does Medicare Still Use COBOL? A Book Chapter by Claude Opus 4.8

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A previous blog entry provided a book chapter, written by Chat GPT, on Medicare claims processing software ("Is it really still in COB...

AI Guest Column 01: Does Medicare Still Use COBOL? A Book Chapter by Chat GPT

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AI CORNER:  Written by Chat GPT. One of a series.  Offered as an example of current AI-managed writing products; not verified. See also: A s...
Tuesday, June 9, 2026

AI Guest Column: Oz and Mulligan on Saving Healthcare Costs

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 AI CORNER: Chat GPT Two Senior CMS Officials on "Saving Costs" - June 2026 MedCityNews, June 9, 2026 (Katie Adams): CMS Dr. Oz on...

CMMI ACCESS Program: Can Well-Intentioned Goals Conceal Adverse Incentives?

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Header:  CMMI produces a JAMA Op Ed on its "ACCESS" technology and chronic care program.  I used an AI-generated essay to explain...