Sunday, July 26, 2026

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

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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  FDA has posted draft guidance updating its policies for communications with payors, such as HEOR info...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...
Monday, July 20, 2026

AI Guest Author: A Detailed White Paper about Payors and Genomics 2017-2026

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Header: An AI-generated 20-page white paper that surveys a decade of articles about payors and genomics.   Here's another adventure in c...

The LabCorp $14M Fine on Tox Testing (Humor)

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 You're probably seen press releases about the recent LabCorp $14M DOJ fine related to urine tox testing. There are some sources that go...

How I Use AI: "Ten Papers on Barriers to Molecular Test Adoption"

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Header: For some questions, AI can search Google or AI can search PubMed more efficiently than I can. Today I asked Chat GPT to search Pub...
Sunday, July 19, 2026

AI Guest Author: Review of H&E AI Breast Cancer Prognosis, versus Standard Methods (21-gene)

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I have seen a scattering of articles that study whether AI interpretations of H&E slides can mirror the prognostic value of molecular te...

AI Can Do More Than You Think: Downloading the PDFs & Busywork

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UPDATE.  I did have one day of success asking Chat GPT in "LLM" mode to download PDF papers and give me a Zip file.  But it took ...

AMA CPT: Call for Comments on September 2026 New Codes; also AI in Code Change Application

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 AMA has a webpage for the September 17-19 Editorial Panel meeting in Minneapolis.  There are limited in person seats; first come first serv...