January 2023
Full Focus: Exploring MolDX and Payer Guidelines for Molecular Testing

Is your lab struggling to navigate MolDX reimbursement guidelines and Technical Assessment requirements? If so, you're far from alone. During this upcoming webinar, we will review the MolDX program and discuss when labs need to apply for a Z-code to receive reimbursement for their panels.

Please join us at 12:00 p.m. EST, Wednesday, Jan. 25, 2023, as we welcome our expert panel to examine MolDX issues and offer strategies to help your lab succeed as the program continues to evolve. Attendees also can receive 1.0 ACCENT credit for completing this AACC-hosted webinar.

During the event, we will:
 
  • Define MolDX and Z-codes.
  • Identify the rules for payment in Local Coverage Determinations (LCDs)/Payer Policy.
  • Explain Laboratory Benefit Management (LBM) and the role these programs play in payer policy and reimbursement for laboratory testing.
  • Define the role of Medical Necessity in the reimbursement landscape.
Exploring MolDX AACC webinar
LATEST NEWS
1. VALID Act Excluded from Spending Package, Payment Cuts Delayed

In a win for laboratory innovation, the VALID Act was excluded from the year-end omnibus spending package recently finalized by Congress, meaning the legislation is effectively dead at this time.

Additionally, labs and Medicare providers will also see significant financial relief from several reimbursement cuts that were expected to take effect in 2023 but will now be delayed. 
The VALID Act policy update
2. Survey: Is it Time to Update CLIA Regulations?

While the VALID Act was stopped, many in the clinical lab community are now discussing whether it's time to update CLIA regulations that haven't been revised in 20 years. Please fill out the brief survey below to share your thoughts on whether it's time to revisit current policies and regulations. Answers will be used to inform Lighthouse's ongoing clinical lab advocacy efforts.
3. Reintroducing Lighthouse Lab Services

As Lighthouse Lab Services has continued to grow in recent years, we've also added several new service lines to help us better serve clinical laboratories and lab professionals. While we greatly value the history of our legacy brands, we believe we strengthen our company and mission as a whole by reintroducing them under the Lighthouse umbrella of services.
New LLS intro video thumbnail
RCM NEWS AND TIPS
1. Why a Z-Code Identifier Doesn't Equal MolDX Reimbursement

Is your lab registering tests with MolDX? Did you know that simply receiving a Z-code identifier doesn't mean your test is now eligible for reimbursement? Check out this blog for details on the Technical Assessment process and proper coding once you've been assigned reimbursement.

DEX z code blog image
2. Next Round of Provider Relief Fund Reporting

The Provider Relief Fund (PRF) Reporting Portal is now open for Reporting Period 4. Providers who received a PRF (General or Targeted) and/or American Rescue Plan Rural payment(s), exceeding $10,000 in total between July 1, 2021, and Dec. 31, 2021, are required to report on their use of funds during RP4. The deadline to submit a report is March 31, 2023, at 11:59 p.m. ET.
3. Three Cost Changes Facing Labs and Providers in the New Year

A perfect storm seems to be on the horizon in the healthcare industry as US providers and facilities continue to face increased costs and a reduction in insurance reimbursement heading into 2023.
Cost changes facing labs in 2023
Deep Dive: 6 Things Labs Need to Be Aware of in 2023
6 things for labs to watch in 2023 blog image
Clinical laboratories and healthcare providers as a whole received a number of welcome reprieves from potential payment cuts and burdensome regulation as 2022 drew to a close. But that doesn’t mean many of these issues couldn’t be resurrected in a different form in 2023.

From the ongoing workforce shortage to the elimination of the DEA X-Waiver, here are six recent developments we’ll be keeping an eye on this year.
UPCOMING CONFERENCES WE'RE ATTENDING
1. Texas Society of Pathologists


2. Q1 Diagnostic Coverage & Reimbursement Conference
CLIA LAB DIRECTOR OPENINGS
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The Lab Insighter is a monthly publication for Lab Owners and Decision Makers.