TAG:
clfs
PAMA Cuts Might Be Reduced to Zero for 2023
By Scott Wallask | From the Volume XXIX, No. 11 – August 8, 2022 Issue
CEO SUMMARY: Congress may soon vote on a new bill that permanently reduces the amount of price cuts to Medicare Part B lab test prices, as specified under the Protecting Access to Medicare Act of 2014 (PAMA). The Saving Access to Laboratory Services Act (SALSA) eliminates a 15% paym…
Coverage, Reimbursement Still Difficult for New Lab Tests
By Robert Michel | From the Volume XXIX, No. 11 – August 8, 2022 Issue
CEO SUMMARY: Bringing a new proprietary diagnostic test to market is an arduous process. It takes patience and planning to complete the journey from test development to payer reimbursement. This slow process stems from the fact that the healthcare reimbursement system is fragmented,…
Labcorp to Buy Outreach, Manage Ascension Labs
By Robert Michel | From the Volume XXIX, No. 3 – February 22, 2022 Issue
CEO SUMMARY: In a blockbuster deal valued at almost half a billion dollars, Labcorp will manage dozens of hospital labs in 10 states on behalf of Ascension Health, one of the biggest health systems in the country. Labcorp will also spend $400 million to acquire certain assets of Asc…
Non-COVID Part B Lab Spend Declined by 15.9% in 2020
By Robert Michel | From the Volume XXIX, No. 2 – January 31, 2022 Issue
MEDICARE PART B CLINICAL LABORATORY FEE SCHEDULE CUTS mandated by PAMA continue to bite deeply. A new government report shows that during fiscal 2020, the Medicare program spent 15.9% less for lab tests, when COVID-19 test payments are excluded. The fed…
Congress Votes: No PAMA Price Cuts for 2022
By R. Lewis Dark | From the Volume XXVIII, No. 17 – December 20, 2021 Issue
IT’S WELCOME NEWS THAT CONGRESS VOTED EARLIER THIS MONTH to defer the PAMA price cuts to the Clinical Laboratory Fee Schedule (CLFS) that were scheduled to take place in 2022. This is a positive development for the finances of the nation’s clinical labs, particularly the smaller, independent labs t…
MedPAC Reports to Congress on Issues in Lab Test Price Survey
By Robert Michel | From the Volume XXVIII, No. 13 – September 27, 2021 Issue
IN THE HALLS OF CONGRESS, A GOOD NEWS/BAD NEWS STORY is unfolding around the multi-year cuts to the prices Medicare pays for clinical laboratory tests. First the good news. In its latest semi-annual report to Congress, the Medicare Payment …
MedPAC Advises Congress on Lab-Data Reporting
By Robert Michel | From the Volume XXVIII, No. 8 – June 14, 2021 Issue
CEO SUMMARY: For years, the clinical lab industry has sought unsuccessfully to get the federal Centers for Medicare and Medicaid Services to address the inequities in the payment formula CMS adopted after Congress passed the Protecting Access to Medicare Act (PAMA). In April, the la…
Any Hope for Relief from PAMA Medicare Price Cuts?
By R. Lewis Dark | From the Volume XXVII No. 2 – January 27, 2020 Issue
It is a notable and rare success for the clinical laboratory profession to convince the House and Senate to pass a law that is favorable to the interests of patients and the clinical laboratories that serve them. Yet that is what happened when Congress passed the Laboratory Access for Beneficiarie…
Lawsuits Alleging Overcharges to Proceed in Two Courts in 2020
By Joseph Burns
CEO SUMMARY: Two lawsuits filed in federal courts against Laboratory Corporation of America and Quest Diagnostics may have consequences for the entire lab industry. The plaintiffs are patients who allege that the two defendant lab companies charged them as much as 10 times more than what …
ASCP, CAP Ask Anthem to Roll Back Price Cuts
By Joseph Burns | From the Volume XXVI No. 13 – September 23, 2019 Issue
CEO SUMMARY: One association representing pathologists says new payment rates that Anthem, Inc., is introducing in 14 states do not cover the costs of performing anatomic pathology and clinical lab testing for the tests in question. Another association says the steep payment cuts threaten…
CURRENT ISSUE
Volume XXXI, No. 4 – March 18, 2024
An expert attorney analyzes the most recent cases of EKRA violations, showing how many labs could be in violation themselves. Also, a major cyberattack on Change Healthcare, owned by UnitedHealth Group, creates disruptions to providers around the country. Other news includes a look at the worldwide pathologist shortage.
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