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Market Price Data Sample From: Independent Clinical Labs

Here is the market price data for independent clinical labs from XIFIN Inc. Lâle White, Founder and CEO of XIFIN, discusses the data with THE DARK REPORT. EDITOR: When XIFIN analyzed the actual private payer p…

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XIFIN Analysis of Its Real Price Data Shows Hospital Lab Price Effect

CEO SUMMARY: In a new analysis of data its lab clients will use to report market prices to CMS, XIFIN Inc., reports private payers paid independent labs a weighted average price that was 19.6% less than what Medicare pays for 20 of its highest-volume tests. By contrast, private payers pa…

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10% PAMA Fee Cut Would Lower Medicare Pay to Laboratories by $400 Million

CEO SUMMARY: Just eight weeks remain before certain clinical laboratories must begin submitting private payer lab test price data to the federal Centers for Medicare & Medicaid Services. A new report …

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PAMA Final Rule Issued, CMS Plans to Cut Rates by 5.6%

CEO SUMMARY: CMS issued its final rule for implementing the laboratory payment reform included in the Protecting Access to Medicare Act of 2014 (PAMA) on June 17. All labs will see significant reductions to the Medicare Part B Clinical Laboratory Fee Schedule that becomes effective on Jan…

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Lab Stakeholders Take Action to Prevent Drastic Cuts in the Medicare Lab Fee Schedule

WITH MANY CLINICAL LABORATORY STAKEHOLDERS anticipating major revenue shortfalls due to the Protecting Access to Medicare Act lab test mar…

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Labs Have Questions for CMS on Proposed Rule

CEO SUMMARY: On September 25, CMS took a long overdue step to issue a proposed rule on how medical laboratories are to report private market prices for lab tests to the Medicare program during 2016. The proposed rule provides insights as to how CMS envisions pricing new tests and advanced…

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CMS Releases Draft of PAMA Market Price Rule

CEO SUMMARY: CMS’ proposed rule details how it will collect private market data, then use that data to establish prices for the Medicare Part B Clinical Laboratory Fee Schedule beginning in 2017. The proposed rule will limit data reporting to les…

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Beware Ides of March! Lawmakers Are in Session

CEO SUMMARY: Few pathologists and lab administrators know that, when the Protecting Access to Medicare Act of 2014 (PAMA) became law last April 1, language in the bill was scored to reduce Part B clinical laboratory test fees by $2.5 billion over 10 years. Congress used those lab…

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Theranos Pursues Different Business Plan in Arizona

CEO SUMMARY: Since its big public debut in late 2013, Theranos has been the subject of keen interest and much skepticism among pathologists and clinical laboratory professionals. Theranos is expanding its presence in Phoenix, Arizona. However, as it does, it looks more like a conventional…

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PAMA’s New Rules Affect Lab Test Pricing, Coverage

CEO SUMMARY: For several reasons, the “Protecting Access to Medicare Act” (PAMA) has the potential to be the most disruptive federal legislation directed at the clinical lab industry since the enactment of CLIA 1988. Following passage of the law, some lab industry groups have taken di…

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