Medicare Laboratory Payment Policy : Now and in the Future.

Detalles Bibliográficos
Clasificación:Libro Electrónico
Autor principal: Dianne, Miller Wolman
Otros Autores: Andrea, L. Kalfoglou, LeRoy, Lauren
Formato: Electrónico eBook
Idioma:Inglés
Publicado: Washington : National Academies Press, 2000.
Colección:Online access: National Academy of Sciences National Academies Press.
Online access: NCBI NCBI Bookshelf.
Temas:
Diagnosis, Laboratory > United States.
Hospitals > Outpatient services > Prospective payment > United States.
Medicare.
Medicare > economics
Clinical Laboratory Techniques > economics
Prospective Payment System
Medicare
Diagnostics biologiques > États-Unis.
MEDICAL.
Medicaid & Medicare.
Diagnosis, Laboratory
Hospitals > Outpatient services > Prospective payment
Medical Care Plans.
Public Health.
Health & Biological Sciences.
United States
Acceso en línea:Texto completo
Tabla de Contenidos:
  • 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
  • CLIAâ€?s Impact on the Laboratory Industry
  • CLIAâ€?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
  • TECHNOLOGYâ€?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

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