CEO SUMMARY: Some lab companies may be prepared to challenge in court the methodology CMS used in setting the requirements of the Protecting Access to Medicare Act of 2014 to conduct a study of private payer market prices for lab tests and use that data to propose new prices for the Part B Clinical Laboratory
Tag: competitive bid
CEO SUMMARY: Just four weeks remain before CMS begins collecting private payer clinical laboratory test price data. Many lab industry executives have charged that Medicare officials are not following the language of the PAMA statute or the intent of Congress. At stake are $5.4 billion in Part B fee cuts that CMS plans to introduce.
CEO SUMMARY: Clinical lab executives and experts who have studied the final rule for PAMA lab test market price reporting are seriously concerned that the design of this rule may put many of the nation’s smallest, but still essential, clinical labs at great risk of financial distress, if not outright failure. In this exclusive analysis,
CEO SUMMARY: Will implementation of the final PAMA private payment rate reporting rule for labs put smaller, community labs at financial risk? Yes, says the National Independent Laboratory Association (NILA). By deliberately setting a standard to exclude private payer payment data from hospital outpatient and outreach labs that receive payments off the CLFS, CMS will
This is an excerpt from a 2,000-word article in the July 5 issue of THE DARK REPORT. The original article is available to paid members of the Dark Intelligence Group.
CEO SUMMARY: Everyone has read the basic facts, but THE DARK REPORT has gone further to analyze the real-world impact of the final rule from the Protecting Access
FOR SEVERAL YEARS NOW, officials at the federal Centers for Medicare & Medicaid Services (CMS) have signaled their unhappiness with the status quo in how coverage guidelines and prices must be established for clinical laboratory testing and anatomic pathology services.
These pages have chronicled some of the analyses and reports commissioned by CMS over the past
CEO SUMMARY: In July, the federal Centers for Medicare & Medicaid Services (CMS) published three proposed rules which would allow it to act independently of Congress to set prices for clinical laboratory testing and pathology services. Analyses of these proposed rules indicate that they would substantially reduce reimbursement paid to labs and pathologists under existing
CEO SUMMARY: It’s been a year with more lows than highs, when viewed through the lens of THE DARK REPORT’S “Top Ten Lab Stories of 2012.” The end of the TC grandfather clause, new policies for prostate biopsy billing, and a dramatic 52% cut to 88305- TC fees were widely reported. But there was equally
CEO SUMMARY: For the clinical lab industry, the concept of competitive bidding for Medicare Part B Clinical Lab Testing may be like the movie “Groundhog Day.” The hero, Bill Murray, kept reliving the same day over and over. So it seems to be with competitive bidding. In the latest replay, RTI Technologies just published a
YOU CAN CONSIDER THIS ISSUE OF THE DARK REPORT TO BE an early warning of the escalating effort by public and private payers to rein in the “soaring cost” of clinical laboratory testing and anatomic pathology services.
The intelligence briefings you will read on the following pages address important topics, specifically: 1) a new Medicare policy