OIG issues fraud alert for physician-lab relationships
Jessica Belle
The Department of Health and Human Services Office of the Inspector General recently issued a special fraud alert that singles out the laboratory-referring physician relationship for its focused attention. The OIG has repeatedly emphasized that a lab providing free or below-market goods or services to a physician who is a source of referrals, or paying a physician more than fair market value for his or her services, could constitute illegal remuneration under the federal anti-kickback statute. In light of this special fraud alert, physicians and laboratories should review their compensation arrangements.
AACC highlights significant concerns with CLFS reimbursement plan
AACC
The American Association for Clinical Chemistry is voicing significant concerns about the impact the Protecting Access to Medicare Act of 2014 may have on the Clinical Laboratory Fee Schedule. Readers will recall the House and Senate passed PAMA in late March, and among other things, it contained a Sustainable Growth Rate patch, a one year delay in the implementation of ICD-10, and a complete overhaul of how tests on the CLFS will be reimbursed beginning in 2017.
Palmetto GBA defining pathology Medicare fraud with new standards
The Pathology Blawg
Palmetto GBA, the Medicare Administrative Contractor for Jursidiction 11 (the Carolinas and Virginias), is taking the rather extraordinary step of defining, using an evidence-based approach, the standards by which certain specimens should be pathologically evaluated. By doing this, Palmetto is placing itself at the forefront of combating Medicare fraud by pathologists and in-office laboratory owners.
How DNA is 'edited' to correct genetic diseases
Science Daily
A major step forward in our understanding of how enzymes "edit" genes has been made by an international team of researchers, paving the way for correcting genetic diseases in patients. Researchers have observed the process by which a class of enzymes called CRISPR — pronounced "crisper" — bind and alter the structure of DNA. The results provide a vital piece of the puzzle if these genome editing tools are ultimately going to be used to correct genetic diseases in humans.
Brief formalin fixation and rapid tissue processing do not affect the sensitivity of ER immunohistochemistry of breast core biopsies
American Journal of Clinical Pathology via Medscape
The decision to initiate treatment for patients with breast cancer is based on the results of tissue biomarker studies including estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2. Breast core needle biopsy specimens are now the primary source for the performance of these tests, particularly if neoadjuvant therapy is being considered. Preanalytic variables may affect the accuracy of ER, PR, and HER2 results.
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