Plaintiff attorneys are asking for damages in excess of $5 million, not including interest and other costs, and seeking class-action status.

The agency is looking to lift the longstanding NCD that restricts patients to one amyloid-detecting positron emission tomography exam in their lifetime.

BCBS last month suggested curtailing coverage for peripheral nerve stimulation devices, used to relieve pain, which drew ire from thousands of physicians. 

Merk & Co. paid the largest amount to the specialty between 2017-2021, followed by Hologic and Pfizer, researchers wrote recently.  

H.R. 4286 also would expand coverage for tobacco cessation in the federal payment program, including counseling and medication-assisted treatment. 

The college issued a detailed breakdown of the 2024 MPFS, offering insight into the “complex” formula for how much the specialty stands to lose. 

Medicare has refused to reimburse for imaging-based colon cancer screening, which is leading to an income-based gap for those who can and cannot receive the exam.

The Medicare Physician Fee Schedule utilizes 2006 cost information to develop practice expense relative values and resulting reimbursements. 

RoyalVibe Health offers direct-to-consumer scanners purported for multiple medical uses, which have not been reviewed or cleared by the agency.  

It’s also the fifth local legislature to do so in 2023, following in the footsteps of Tennessee, Washington, Maryland and New Mexico. 

The agency issued its solicitation as part of the recently released 2024 Hospital Outpatient Prospective Payment System proposed rule.