The Medicare program will scrap local medical review in favor of uniform coverage policies for 23 clinical laboratory tests - In Brief - Brief Article

Healthcare Financial Management, Feb, 2002

The Medicare program will scrap local medical review in favor of uniform coverage policies for 23 clinical laboratory tests, the Centers for Medicare and Medicaid Services (CMS) announced in a final rule published in the November 23, 2001, Federal Register. The policies mandate coverage for such common activities as blood counts, thyroid and iron studies, lipid tests, and HIV diagnosis and monitoring.

The 23 tests account for 43 percent of carrier lab services and 51 percent of carrier lab-payments. The new approach is designed to ease physician's regulatory burden. The final rule, which will become effective November 25, 2002, affects all clinical labs in physician offices, hospitals, and other healthcare facilities.