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CMS

Compliance & Safety, General Information, Test Utilization

Lipid & Vitamin D policy for Medicare patients

Traditional Medicare insured patients who have a Lipid Panel or Vitamin D 25 ordered more than once per 12 months are not covered due to medical necessity.*

If testing is indicated, you will need to provide an appropriately executed Advance Beneficiary Notice (ABN) for Corewell Health Southeast Laboratories and Advance Beneficiary Notice for Corewell Health Southwest and West Laboratories signed by the patient indicating they would like testing and understand they may be financially responsible for payment (ABN: Option 1). ABN must be submitted with specimen.

For testing ordered inside this frequency range without an ABN, Corewell Health will implement an automatic cancellation. Continue Reading

Compliance & Safety, General Information

Pathology Narratives Release Hold Removed for Weekends and Holidays

Effective July 1, 2021, Pathology and Radiology Result Narratives will no longer be held on weekends and holidays. All finalized result narratives will be released at 6 a.m. and 12 p.m. daily. This adjustment aligns with the 21st Century Cures Act and corresponding CMS mandate to allow data to flow freely and securely between providers, payers, and patients.

Of note, patients may be able to see results in MyChart prior to a provider seeing the results. Ordering providers should consider discussing potential outcomes with patients to prepare patients for results. Results should only be held if releasing the result puts the patient at risk of physical harm, or the patient requests the information not be shared.

More information related to the 21st Century Cures Act and established interoperability requirements can be found on the Information Governance Insite page (Internal). Contact Information Governance at InformationGovernance@spectrumhealth.org with any questions or use the Contact Us link above.

Compliance & Safety, General Information

Inform: Interoperability and Information Blocking

The 21st Century Cures Act and Office of the National Coordinator for Health Information Technology (ONC) Final Rule states that Spectrum Health cannot engage in practices that interfere with access, exchange, or use of electronic health information (EHI), otherwise known as Information Blocking, unless a specific Information Blocking exception applies. Continue Reading