CMS Oversight of Medicare Payments for Genetic Testing

This report by the Office of Inspector General evaluates CMS's oversight of Medicare payments for molecular pathology genetic tests, specifically CPT code 81408. It identifies significant deficiencies in ensuring compliance with Medicare requirements, leading to a potential risk of up to $888 million in improper payments. The report includes recommendations for CMS to enhance oversight and recover improper payments, highlighting the importance of effective monitoring in healthcare billing.