Compliance with Final PAMA Rules

A Webinar Series on Compliance with Final PAMA Rules for Clinical Laboratories

The final PAMA rule was released June 17 and will require laboratories and physician offices to begin reporting information on the payments they receive from private payers starting January 1, 2017. Join Arnold & Porter and XIFIN for an in-depth webinar series, Compliance with Final PAMA Rules for Clinical Laboratories. 

This regulation will transform Medicare's payment system for clinical laboratory testing while establishing significant new compliance demands. Arnold & Porter and XIFIN have partnered to create a series of three in-depth webinars that help laboratories prepare to comply with the rules and succeed in the new reimbursement environment.

Applicable Laboratories: Is Your Lab Required to Report?

CMS proposed to define an Applicable Laboratory so as to exclude many hospital laboratories and nearly all physician office laboratories, but the Final Rule extends this designation to about nine thousand additional entities.  Hospital outreach laboratories may participate, and they have an incentive to do so since about half of Medicare’s spending on laboratory tests occurs in hospital settings.   Will median Medicare payment rates be more representative of the market as a result?   

Webinar Details

Speakers

  • Rina Wolf, Vice President, Commercialization Strategies, Consulting & Industry Affairs, XIFIN
  • Paul Rudolf, Partner, Arnold & Porter Kaye Scholer
  • Jennifer B. Madsen, Health Policy Advisor, Arnold & Porter Kaye Scholer

Private Payor Data Reporting: What Information Must Be Reported, When, and How?

PAMA requires laboratories to report private payor rates, excluding price concessions. Every rate paid by every payor for each test on a laboratory's test menu adds up to a lot of data. The Final Rule expands the reporting requirement to bring in hospital outreach laboratories. What are the immediate operational concerns for laboratories? What compliance demands should they prepare for?

Webinar Details

Speakers

  • Rina Wolf, Vice President, Commercialization Strategies, Consulting & Industry Affairs, XIFIN
  • Thomas A. Gustafson, Senior Policy Advisor, Arnold & Porter Kaye Scholer
  • Kristen M. Hicks, Partner, Arnold & Porter Kaye Scholer

Advanced Diagnostic Laboratory Tests: What Considerations for Launching a New Test?

PAMA gives special treatment to Advanced Diagnostic Laboratory Tests (ADLTs) including unique billing codes, Medicare payment at their list price at launch, and annual rate changes. To obtain ADLT status, laboratories must submit an application to CMS and prove that their test provides new clinical information that can't be gotten from other tests. CMS will give G codes to ADLTs and unique identifiers to laboratories for FDA-approved tests, but the process for getting them is unclear. And which of these steps should laboratories take first when launching a new test?

Webinar Details

Speakers

  • Rina Wolf, Vice President, Commercialization Strategies, Consulting & Industry Affairs, XIFIN
  • Paul Rudolf, Partner, Arnold & Porter Kaye Scholer
  • Jennifer B. Madsen, Health Policy Advisor, Arnold & Porter Kaye Scholer

Arnold & Porter LLP is an international law firm of more than 700 lawyers with offices in Brussels, Denver, Houston, London, Los Angeles, New York, San Francisco, Silicon Valley and Washington, DC. The firm maintains more than 30 practice areas spanning a broad spectrum of the law, with a primary focus on litigation, transactional matters and regulatory issues.

Details

Arnold & Porter
EVENT TYPE:
Webinar
WHEN:
Jun 26, 2016
XIFIN SPEAKER(S):

Rina Wolf, Vice President, Commercialization Strategies, Consulting & Industry Affairs, XIFIN

SPEAKER(S):

Thomas A. Gustafson, Senior Policy Advisor, Arnold & Porter Kaye Scholer 

Kristen M. Hicks, Partner, Arnold & Porter Kaye Scholer

Jennifer B. Madsen, Health Policy Advisor,  Arnold & Porter Kaye Scholer

Paul M. Rudolf, Partner, Arnold & Porter Kaye Scholer