Monday, June 27, 2016

An Excellent 10 Page Summary of the New PAMA Lab Pricing Rule

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On June 17, CMS released a lengthy rulemaking to implement PAMA 216, the market based reform of the clinical laboratory fee schedule. The ...
Sunday, June 19, 2016

Some Quick Thoughts on Special Features of the Final PAMA Rule

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On Friday evening, June 17, 2016, CMS released the final PAMA rule.  (For links see HERE ). While encyclopedic summaries are availabl...
Friday, June 17, 2016

CMS Posts Final PAMA 216 Lab Pricing Regulations: With Some Key Links

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On June 17, 2016, at 4 pm, CMS posted the final 245 page rule making for PAMA Section 216, the massive overhaul of laboratory test pricing. ...
Friday, June 10, 2016

CMS Posts MAC Proposed Gapfill Prices for New Molecular 2016 Codes

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Last summer, CMS shunted a number of new incoming 2016 CPT codes for molecular tests to the MAC Gapfill process. CMS has posted the MAC pr...
Thursday, June 9, 2016

Genomeweb: The Appearing, Vanishing Medicare Breast Cancer LCD (May 2016)

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Genome has two articles on the appearance and disappearance of Noridian MolDX LCD DL36730, which briefly proposed to lockstep Medicare breas...

Jennifer Lawrence Signs On for Theranos Biopic

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June 9, 2016 "Jennifer Lawrence Signs On For Big Screen Theranos Adaptation." Engadget.  By Andrew Dalton.   Here .  (Deadlin...

Clever Blog on PBMs: the Junction of Economics, Analytics, Health Outcomes, and Policy

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There is a lot going on at the junction of pharmacoeconomics and health policy, as seen in the ever-present dialog over drug prices and heal...
Wednesday, June 8, 2016

New York State's Proposal to Redefine Approval Processes for Advanced LDTs

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On March 1, 2016, the New York State Department of Health - which has special rules that apply nationally to labs processing New York origi...
Monday, June 6, 2016

Registration Open: Sign Up for July 18 CMS CLFS Meetings

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On June 6, 2016, registration opened for the paired CMS CLFS meetings to be held on the campus in Baltimore on July 18, 2016. The public m...
Friday, June 3, 2016

CMS Posts Draft Decision on Gender Dysphoria Surgery (Leave at MAC Discretion)

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On June 2, 2016, CMS posted a proposed National Coverage Decision for gender dysphoria surgery (e.g. gender reassignment surgery).  The prop...

NantHealth Has Successful IPO; Raises $91M; Stock Pops

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NantHealth scores $91M in its June 2, 2016 IPO.   From an offering price of $14, the share price jumped to almost $18.   With about 5% of th...
Thursday, June 2, 2016

CMS Posts Info for Lab Advisory Panel Meeting July 18 (Same Day as Gapfill Meeting)

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CMS has posted a formal announcement that the Advisory Panel on Clinical Diagnostic Laboratory Tests will meet on July 18, 2016, at CMS in B...
Wednesday, June 1, 2016

CMS Payments for Clinical Trials: Keeping Up With New Category A, B Policy

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From December 2015 to June 2016, CMS and FDA update policies that describe when Medicare can cover healthcare payments for patients in clini...

Judges Find Medicare Law Impenetrably Confusing

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This week, Politico Pro picked up on a California judge's ruling that Medicare is...confusing and impenetrable.   There are several famo...
Tuesday, May 31, 2016

CMS to Hold MEDCAC on Chronic Venous Disease (July 20, 2016)

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On May 6, 2016, CMS announced it will hold a July 20, 2016, MedCAC on chronic venous disease of the lower extremities.  Webpage for the meet...