TAG:
national independent laboratory association
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…
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…
Market Price Report Rules Must Address All Issues
CEO SUMMARY: Under the Protecting Access to Medicare Act, CMS must collect market price and volume data from certain labs beginning January 1, 2016. CMS will use this data to establish Part B clinical laboratory fees beginning in 2017. One lab association representing community a…
Protecting Access to Medicare Act of 2014 Could Harm Independent Community Labs
In the Protecting Access to Medicare Act of 2014 (PAMA), the Center for Medicare and Medicaid Services (CMA) is directed to collect market price data and use the data to establish prices for the Medicare Part B Clinical Laborato…
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…
Congress’ New SGR Law Has Mixed News for Labs
CEO SUMMARY: Once again, the lab industry faces a mixed bag following passage of a new law by Congress last week. Besides the one-year fix for the SGR, H.R. 4302 also has language that may defer adjustments to Medicare Part B lab test fees until 2017 and creates a new procedure for Medica…
CMS’ Proposed Lab Rules May Not Fly with Congress
CEO SUMMARY: Many clinical lab administrators have noticed the new activism at the federal Centers for Medicare Medicaid Services (CMS) when it comes to control of establishing prices for clinical laboratory tests. In this exclusive interview, two long-time advocates for the National Inde…
Unpaid for Molecular Tests, Some Labs Are Closing
THERE IS GREAT FRUSTRATION ACROSS THE LABORATORY MEDICINE PROFESSION on the subject of getting paid for claims covered by the new Tier I and Tier II molecular test CPT codes. We are now in the fifth month of the year and pathologists are still waiting for an acceptable resolution to this situation. …
Blue Cross Execs Discuss Reasons for New Policies
CEO SUMMARY: In recent months, officials from the Blue Cross and Blue Shield Association (BCBSA) have responded to the concerns about new billing protocols for services provided as part of the BlueCard program and voiced by such clinical lab associations as the California Clinical Laborat…
Congress Likely to Pass Deep Cuts in Lab Test Fees
CEO SUMMARY: All signs point to a potentially dismal financial outcome for the clinical lab testing industry as Congress tries to trim spending by $1.2 trillion over the next 10 years. At least three proposals to significantly cut lab test reimbursement are in active debate by fe…
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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