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Preventing Genetic Testing Fraud: 5 Actions for Health Plans

Healthcare IT Today

Department of Health and Human Services (HHS) analysis showed Medicare payments for genetic testing quadrupled from 2016 to 2019. Now, as new genetic tests unlock advancements that can improve health and well-being—even for those suffering from the rarest of genetic conditions—the risk for fraud, waste and abuse in genetic testing is high.

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Home Health PPS Proposed Rule for CY2023: More Bad News for the Home Health Industry

Hall Render

CMS chose to forego assessing behavior in the last two PPS rules, because the COVID-19 pandemic led to significant changes in utilization, which were not responses to PDGM. CMS concluded that it would be difficult, if not impossible, to identify changes to PDGM and those due to COVID-19. Behavioral Analysis and COVID-19.