Rising CMS Scrutiny: What Labs Need to Know | McDermott

McDermott Will & Schulte, a global law firm

VIRTUAL

Rising CMS Scrutiny: What Labs Need to Know

Webinar

April 22, 2026

Event details

April 22, 2026

This event is in the past. See recordings and other materials from this event below.

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 addressed key areas of increased CMS scrutiny, including molecular and genetic testing, and claims involving clinical validity/utility and supporting medical necessity documentation.

Discussion topics included:

  • 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
Speakers