January 6, 2020 Intelligence: Late Breaking Lab News

On Dec. 19, Congress passed a year-end spending bill that included the Laboratory Access for Beneficiaries (LAB) Act. The bill went to the President for his signature. The bill mandates that the federal Centers or Medicare and Medicaid Services (CMS) delay by one year having labs report their private payer lab test data. This means no reporting will be required “during the period beginning Jan. 1, 2020, and ending Jan. 1, 2021,” with reporting required “during the period beginning Jan. 1, 2021, and ending Mar. 31, 2021.”
On Jan. 3, 2020, CMS issued a statement that it was implementing a one-year delay in the reporting of private payer lab test price data until Jan. 1, 2021. In its announcement, CMS also said that cuts to the 2020 Medicare Clinical Laboratory Fee Schedule (CLFS) would be implemented, capped at 10%, and that “the reduction cap is set to rise to 15% in 2021.”
The second section of the LAB Act requires CMS, within 90 days of the LAB Act’s enactment, to enter into an agreement with the National Academies of Sciences, Engineering, and Medicine to “conduct a study to review the methodology the Administrator has implemented for the private payer rate-based clinical laboratory fee schedule.” The language in the LAB Act specifies that this study is to consider “how to implement the least burdensome collection process,” while resulting “in a representative and statistically valid data sample of private market rates from all laboratory market segments, including hospital outreach laboratories, physician office laboratories, and independent laboratories.” Clinical laboratory associations that supported passage of the LAB Act hope that an objective, third-party review of the methodologies used by CMS to collect, analyze, and determine the lab test prices paid by private health plans will address the multiple problems that industry experts have voiced to CMS officials. Meanwhile, CMS will enact the third year of 10% cuts based on 2017 data.


In Canada, on Dec. 18, LifeLabs disclosed a data breach involving 15 million patients. Stolen data was “patient name, address, email, login, passwords, date of birth, health card number, and lab test results,” said LifeLabs. The company confirmed it paid a ransom fee to the unknown hackers. Canada’s population is 37.5 million people, so this breach was significant.

That’s all the insider intelligence for this report.
Look for the next briefing on Monday, January 27, 2019.

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