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medicare laboratory

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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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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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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Competitive Bidding: Once Again, It’s Back!

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 rep…

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San Diego Labs Pursue Return of Bids from Medicare Officials

HAVING WON a significant court ruling last spring that stopped the Medicare Laboratory Testing Competitive Bidding Demonstration Project dead in its tracks, three San Diego-area laboratories are scheduled to return to court today. Important legal issues still need resolution. At today’s scheduled …

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2008’s Top Ten Lab Stories Lacked Disruptive Impact

CEO SUMMARY: For the first time in recent memory, a year has passed without major tumult or disruptive change in the laboratory industry. Our list of the Top Ten Most Important Stories of 2008 reflects a rather quiet year when compared to most years of this decade. Howeve…

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New Senate Bills Include Repeal of Competitive Bid

CEO SUMMARY: One proposed Senate bill would repeal the laboratory competitive bidding demonstration project, replace the 10.1% cut to physician fees with a 1.1% increase, and extend the so-called technical component (TC) grandfather clause. Senator Max Baucus (D-Montana),…

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Courts Uphold Labs’ Challenges on CMS’ Rules

SINCE MARCH 31, THE FEDERAL CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) has lost two decisions in two different U.S. district courts. Though each case addressed fundamentally different issues, the rulings were remarkably similar. In both cases, the courts questioned CMS’ fai…

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Three San Diego Labs Stop Competitive Bid Demo

CEO SUMMARY: Last Tuesday, a federal judge handed a big court victory to the three plaintiffs in their lawsuit seeking to delay or stop implementation of the Medicare Laboratory Competitive Bidding Demonstration pilot in the San Diego area. In his written opinion, the judge ruled in favor…

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April 4 Fed Court Ruling Opened Door to Injunction

CEO SUMMARY: Federal Judge Thomas J. Whelan’s ruling on three key legal points on Friday, April 4, was the first court victory needed by three San Diego-area labs in their lawsuit to prevent the Medicare Laboratory Competitive Bidding Demonstration in San Diego from proceeding. Judge Wh…

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