VIRTUAL
Webinar
April 22, 2026
April 22, 2026
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