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CodeMap Compliance Briefing: 4/23/2004

Editor's Welcome

Last week we responded to several questions submitted by CodeMap subscribers. One of our responses concerning the ability to mark-up the price of send out testing caused some controversy. In our reply we stated that no Medicare rules or regulations prohibit hospitals from charging Medicare more than the actual cost of send out tests performed for outpatients. This is an accurate statement.

However, many subscribers pointed out that in their states, state law prohibits hospitals and other providers from marking-up the prices of send out testing. This is also completely accurate.

In order to clear up this matter, this week's CodeMap Compliance Briefing will look at the laws currently in effect in California, Florida, Michigan, and Arizona that prohibit providers from marking-up tests sent out to other laboratories.

We apologize for any confusion this may have caused for subscribers in the above states. If you operate in any other state, your provider organization should be able to charge Medica....

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