Title Medicare Laboratory Payment Policy : Now and in the Future

Published Washington : National Academies Press, 2000

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Description 1 online resource (264 pages) Series Online access: National Academy of Sciences National Academies Press Online access: NCBI NCBI Bookshelf Contents Medicare Laboratory Payment Policy -- Copyright -- REVIEWERS -- Preface -- Acknowledgments -- Contents -- Summary -- INTRODUCTION -- THE LABORATORY INDUSTRY -- THE CURRENT MEDICARE PAYMENT SYSTEM -- GOALS FOR A PAYMENT SYSTEM -- ASSESSMENT OF THE CURRENT MEDICARE PAYMENT SYSTEM -- RECOMMENDATIONS -- CONCLUSION -- REFERENCES -- 1 Introduction -- ORIGINS OF THIS STUDY -- STATEMENT OF TASK -- THE IOM STUDY PROCESS -- GOALS FOR A PAYMENT SYSTEM -- CLINICAL LABORATORY SERVICES COVERED BY MEDICARE -- THE MEDICARE PROGRAM What Types of Laboratory Services Are Included in the Medicare Laboratory Fee Schedule?ORGANIZATION OF THE REPORT -- REFERENCES -- 2 Background and Environmental Trends -- BACKGROUND ON THE CLINICAL LABORATORY INDUSTRY -- Sites of Service -- Geographic Distribution -- Size and Distribution of the Market -- Trends in Expenditures for Laboratory Services -- Financial Strength of the Laboratory Industry -- MEDICARE PART B CLINICAL LABORATORY TRENDS -- Medicare Part B Spending -- ENVIRONMENTAL TRENDS -- Regulatory Trends Clinical Laboratory Improvement Amendments of 1988Test Complexity and Laboratory Certification -- CLIA�s Impact on the Laboratory Industry -- CLIA�s Impact on Quality -- Occupational Safety and Health Administration -- MINIMIZING FRAUD, WASTE, AND ABUSE -- Stark Amendments -- OIG Investigations -- Medical Necessity Review -- PAYMENT TRENDS -- Medicare Shift to Prospective Payment Systems -- Growth of Managed Care -- RESPONSE FROM THE INDUSTRY TO ENVIRONMENTAL TRENDS -- Market Consolidation and Network Development Growth of Hospital-Based Laboratory Outreach ProgramsSUMMARY -- REFERENCES -- 3 Technology Trends in the Clinical Laboratory Industry -- AUTOMATION -- Preanalytic Stage -- Analytic Stage -- Postanalytic Stage -- INFORMATION TECHNOLOGY -- LABORATORY MEASUREMENT AND TESTING TECHNOLOGY -- Esoteric Tests -- Genetic Testing -- Pharmacogenomics -- Nanotechnology -- TECHNOLOGY�S EFFECT ON SITE OF SERVICE -- Point-of-Care Testing -- Home Testing -- EFFECT ON CLINICAL LABORATORY STAFF REQUIREMENTS -- SUMMARY -- REFERENCES 4 Description of the Current Medicare Payment System and Its Historical RootsINTRODUCTION -- THE FDA APPROVAL PROCESS -- CODING POLICY -- Coding Updates -- Panel Codes -- Codes for New Technology -- Ambiguities in Code Use -- CLAIMS PROCESSING -- MEDICARE COVERAGE POLICY -- National Coverage Decisions -- Local Medical Review Policy -- Claims Denials -- Advanced Beneficiary Notice -- Negotiated Rulemaking -- MEDICARE PAYMENT POLICY -- Early History of the Payment System -- DEVELOPMENT OF THE CURRENT SYSTEM -- ELEMENTS OF A PAYMENT SYSTEM Notes ""Type of Payment"" Bibliography Includes bibliographical references Notes English Print version record Subject Diagnosis, Laboratory -- United States Hospitals -- Outpatient services -- Prospective payment -- United States Medicare. Medicare -- economics Clinical Laboratory Techniques -- economics Prospective Payment System Medicare MEDICAL. Medicaid & Medicare. Diagnosis, Laboratory Hospitals -- Outpatient services -- Prospective payment Medicare Medical Care Plans. Public Health. Health & Biological Sciences. SUBJECT United States Subject United States Form Electronic book Author Andrea, L. Kalfoglou LeRoy, Lauren ISBN 9780309564984 0309564980 0309072662 9780309072663 1280185228 9781280185229

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