Tuesday, November 18, 2025

Brief Blog: Winter CPT Code Applications Out for Comment (November 15-30)

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 AMA's next CPT meeting is in Palm Springs, February 5-7, 2026. https://www.discoveriesinhealthpolicy.com/2025/11/ama-opens-registration...

Resources: Value in Health Offers Special Issue on AI in Health Economics (November 2025)

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 Value in Health, the official journal of ISPOR, the international pharmacoeconomics/HEOR organization, focuses on AI in HEOR for November 2...

Update: CAP Accreditation Allows "Distributed Model" Testing - But AMA CPT PLA Will Not

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In recent quarters, a number of PLA applications have been rejected either because they were " dry lab only" services (e.g. start...
Monday, November 17, 2025

Legislation: Where to Find It: Delay Lab Pricing 30 Days. Spend $50B for Rural Health Technology.

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 Too pieces of recent legislation and where to find them. UPDATE - December 19 - HHS creates Office of Rural Health Transformation.  AHA .  ...

Siemens' Remarkable Comments to CMS on Software Reimbursement - the New "Must-Read?"

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 For several years CMS has struggled with changing, vague, or counterproductive policies for how topay for software-dominant services.   Thi...
Sunday, November 16, 2025

Prasad & Makary: Radical New Ideas for Drug Approvals; Do They Matter to Diagnostics??

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 On November 12, 2025, NEJM published an important new essay by Vinay Prasad MD and Martin Makary MD, the head of drug approvals and the com...
Friday, November 14, 2025

ACLA Scores Short-Term Win in PAMA Pricing!

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With the budget that reopened the government on November 13, 2026, ACLA scored a short term win in delaying PAMA cuts.  I'll quote them...
Thursday, November 13, 2025

Trump Administration: Far Less Rulemaking 2025 vs 2024

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Did the Trump Administration do far less rulemaking in their first year than Biden in year four? Last year, the Physician Fee Schedule final...

For-Example AI Essay: CLIA Registration but not a License [REVISED]

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[REVISED] Someone was talking to me about a lab having "CLIA Registration but not a License." The question is a source of immediat...

AMA Opens Registration for Palm Springs CPT Meeting (February 5-7, 2026, Grand Hyatt)

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AMA has opened registration for the February 5-7, 2026, CPT Editorial Panel meeting in Palm Springs, CA.   The location is the Indian Wells ...

AI Chat GPT 5 Explores the Rules for CAP's Distributive Testing CLIA Model

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I've heard for a number of years that CAP allows "distributive testing" of parts of one  complex test when two labs formally c...
Wednesday, November 12, 2025

John Oliver Does Not Like Medicare Advantage

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 John Oliver turns his attention to Medicare Advantage in a recent episode. I know what I think, so I asked Chat GPT 5 what it thought of th...

Hot News: AMA Moving PLA Applications to the Main CPT Application Portal

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Here's an exciting email from AMA CPT, arriving on November 12, 2025.  Effective in December, PLA code applications will be handled thro...
Tuesday, November 11, 2025

Amal Thommil / DeciBio / Updates Us on Reimbursement for MRD

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  Amal Thommil , Senior Research Associate at DeciBio , regularly updates us on coverage for minimal residual disease testing.  Each updates...