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Reimbursement In Brief

OIG recommends that CMS lower lab-test payment rates and consider instituting copayments. Imaging groups urge Medicare agency to halt charge compression. More reimbursement briefs.

Medicare paid between 18 and 30 percent more than other insurers for 20 high-volume and/or high-expenditure laboratory tests, such as prostate-specific antigen testing, according to a June 11 report from the HHS Office of Inspector General. OIG determined that Medicare could have saved $910 million, or 38 percent, if it had paid providers at the lowest established rate in each geographic area.

OIG found that state Medicaid programs and most Federal Employees Health Benefits plans use the Medicare Clinical Lab Fee Schedule...

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