Very Brief Blog: Seema Verma's September Blog on Program Integrity; RFI Due Nov. 20

CMS and HHS got a lot of press for wide-ranging new proposed rules regarding anti-kickback-statute and Stark laws, released for public comment October 9 (entry point here).  Generally, these aim to make value-based-contracting easier, but specifically, they usually leave out the lab industry (as if no good value-based healthcare contracts could involve the lab industry).

Here's another CMS program integrity workstream:

I had missed a lengthy Seema Verma blog on October 21 in which she discussed wide-ranging CMS efforts on the program integrity front.  Worth reading; here.  (Hint: She specifically calls out scandals in the two areas which are orthotic braces, and lab genetic testing.)

See a trade press article about Verma's blog here.

At the same time, CMS Program Integrity released a 12-page view of how they frame their changing mission, including a Request for Information (e.g. a request for public comment).  The RFI comments are due November 20, but even if you miss that deadline, the RFI may still be worth a look.

And finally, CMS Program Integrity also released a 14 page view of how they want to leverage advanced technologies, including AI or Machine Learning for medical review.