In step with growing Medicare spending on genetic testing, the US Department of Health and Human Services’ Office of Inspector General is also tracking increases in fraudulent billing practices.
The OIG reported in August that spending by the Centers for Medicare & Medicaid Services on laboratory testing increased 6 percent in 2018 to $7.6 billion compared to $7.1 billion in 2017, despite rate reductions stipulated under the Protecting Access to Medicare Act. While payment rates decreased for 75 percent of lab tests from 2017 to 2018, spending on genetic tests doubled year over year to approximately $1 billion. Although 2018 had the largest lab test spending increase for CMS since the passage of PAMA in 2014, some of the spending increases were the result of changes in test volumes and the move to a national fee schedule, OIG said.
Meanwhile, OIG attributed spending increases for genetic tests – which comprised