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CMS Will Monitor Certification Compliance

Reprint from Focus On, 2001, Issue 6

During 2002, Centers for Medicare and Medicaid Services (CMS), Office of the Inspector General (OIG) will begin scrutiny of laboratory testing practices. They will use the CLIA certification and Medicare billing records to assess compliance with testing certificates.

Audit your laboratory tests and verify that any offered test complies with your certificate. Laboratories that maintain a certificate of waiver must perform only waived laboratory tests. Since there are both waived and moderately complex kits for many of the same assays, it is possible to order a moderately complex test kit for use in a waived laboratory. This change in test materials could result in your laboratory's inability to be reimbursed for patient testing.