Saturday, November 4, 2017

Variable Prices Per Test for EGFR Testing (Medicare, 2015)

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In CY2015, CMS had a flat and fixed fee schedule price for EGFR testing of $329.18 (for AMA CPT code 81235, common variants.)  This gene is...
Friday, November 3, 2017

Very Brief Blog: CDC Deck on Trends in National BRCA Testing (August 2017)

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In August 2017, CDC released an 18 slide deck on US utilization of BRCA testing (through 2014).  Online here .   Around 2007, rates per 100,...
Thursday, November 2, 2017

CMS Publishes Physician Fee Schedule Policies for CY2018 (DPP, Biosimilar, AUC)

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On November 2, 2017, CMS published annual rulemaking for PFS policies for CY2017.    The homepage is here .   The final typeset version appe...

Very Brief Blog: How Will MolDx Handle the Transition to Single Price Tier Two Codes?

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UPDATE:  BY DECEMBER 2017, MOLDX HAD TAKEN DOWN  ITS SPECIAL TIER 2 GENE BY GENE PRICES.    IT WILL PROBABLY USE  FLAT PAMA PRICES ...

CMS Posts State Level Payment Data for Part B for CY2016: MoPath

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CMS annually posts both national payment data by CPT code ( here ) and by state ( here ).  Specific to genomics, I've done an initi...

Quorum Consulting Acquired by Navigant (NYSE)

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San Francisco's leading boutique pharma and healthcare consultancy, Quorum Consulting , will be acquired by Navigant for an undisclosed ...
Wednesday, November 1, 2017

CMS Publishes CY2018 OPPS Rule; Loosens Bundling on Hospital-Outpatient ADLT Tests

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HOW TO COMMENT ON 14 DAY RULE ERRORS:  SEE NOVEMBER 21 BLOG HERE . _________ On November 1, 2018, CMS released the "public inspecti...
Tuesday, October 31, 2017

OVERVIEW OF CMS MOLECULAR PATHOLOGY UTILIZATION IN CY2016

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On October 19, 2017, CMS released its CY2016 Part B national utilization files - here . I've looked at the Molecular Pathology codes, ...

Very Brief Blog: CMS Releases National 2016 Part B Data

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CMS releases three kinds of national Part B data:  First, national utilization for the prior year, typically in November.  Second, utilizati...

Very Brief Blog: Digital Therapeutics Coalition Formed

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According to an article in MobiHealthNews, a new coalition of startups in the "digital therapeutics" space has formed.   This is a...
Monday, October 30, 2017

Very Brief Blog: Talk on Diabetes Insulin Pumps & Medicare Policy (Intl Diab Tech Mtg, Bethesda, Nov. 2, 2017)

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I'm giving a talk on Thursday, November 2, 2017, in Bethesda at the Diabetes Technology Society international annual meeting.   The conf...
Sunday, October 29, 2017

NEHI Holds Webinar on KYMRIAH Pricing; Releases White Paper on Value Based Oncology Drug Pricing

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On October 24, 2017, NEHI released a 33 page white paper on new approaches to value-based oncology drug pricing.  And on October 26, NEHI he...
Thursday, October 19, 2017

A Visual View of The Weird Intersection of BRCA Coding and PAMA Pricing

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In an earlier blog we presented lab-specific CMS payment data for BRCA testing ( here ) and how to explain CMS's topsy-turvy BRCA pricin...

HHS Posts 17 Internally Generated Innovation Projects

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In the last few weeks, the head of CMS has written a WSJ op ed calling for a reboot of the CMS Innovation Center ( here ).  And the new head...

Very Brief Blog: New Leader Promises New Direction at AHRQ

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On October 17, 2017, the new leader of the Agency for Healthcare Research and Quality (AHRQ) published a detailed blog on his plans for inno...