Unbundled Lab Payments Could Add $10B to Medicare, GAO finds

The Centers for Medicare & Medicaid Services’ new clinical lab fee schedule was supposed to save hundreds of millions of dollars. But a subtle change in the way Medicare pays for panels of tests could end up costing the program billions.

One particular change in the fee schedule enables labs to significantly up-charge for panel tests, according to an analysis by the Government Accountability Office (GAO). Previously, Medicare always paid a bundled rate for panel tests—rather than paying for each component test individually—regardless of how labs submitted their claims. But in the new schedule, labs can bill for each test individually if they submit claims that way.

Source: https://www.fiercehealthcare.com/payer/flaw-cms-lab-fee-schedule-could-cause-up-to-10b-waste-next-2-years-gao