Overview
The Centers for Medicare & Medicaid Services (CMS) and its contractors have significantly intensified their focus on clinical laboratory testing, subjecting laboratories to unprecedented levels of audits, claim denials, and enforcement activity. From Unified Program Integrity Contractor (UPIC) audits to Medicare payment suspensions, laboratories face mounting compliance pressures that demand immediate attention.
This webinar will address key areas of increased CMS scrutiny, including molecular and genetic testing, and claims involving clinical validity/utility and supporting medical necessity documentation.
Discussion topics include:
- CMS coverage decisions, medical necessity requirements, MAC audit procedures, and recent audit trends and enforcement patterns
- Common compliance gaps that trigger contractor reviews, along with practical strategies to strengthen billing practices proactively before issues arise
- The current enforcement landscape, including potential False Claims Act exposure and strategies for navigating government inquiries
- Unique compliance considerations for precision medicine and advanced testing platforms
Continuing Legal Education (CLE) credit is pending. McDermott Will & Schulte is an approved provider and can provide credit in California, Illinois, and New York. McDermott Will & Schulte is a sponsor and will apply for credit in Delaware, Florida, Georgia, Tennessee, Texas, and Virginia when lawyers licensed in these jurisdictions are in attendance. We can issue reciprocal credit for lawyers licensed in Connecticut and New Jersey. For all other jurisdictions not listed, attendees will be provided with a Universal Certificate of Attendance which they may use to self-apply for CLE credit in their state of admission. Attendees should contact their state’s CLE Board for current rules, regulations, and guidance.