Webinar: Medicare’s Market-Based Payment Startup: Strategic Options & Compliance Red Flags for Labs

Medicare Market-Based Payment

Laboratory Economics webinar "Medicare's Market-Based Payment Startup: Strategic Options & Compliance Red Flags for Labs" discussed how the future structure of the lab market will be fundamentally altered by Medicare's new market-based payment system. Virtually every payer category will be impacted, with profound consequences for all laboratories. XIFIN Executive Chairman & CEO, Lâle White spoke in this webinar.

Featured XIFIN Speaker:

Lâle WhiteExecutive Chairman & CEO, XIFIN, Inc.


Dennis Weissman, President, Dennis Weissman & Associates, LLC

Additional Speakers:

Thomas Hirsch, President, Laboratory Billing Solutions
Karen Lovitch, Leader, Health Law Practice at Mintz Levin

Medicare’s new market-based pricing system has hurt the “bottom-line” of most clinical laboratories nationwide, from the largest publicly traded labs to the vast majority of hospital based, physician office and independent labs. Importantly, the way Medicare has decided to pay for panels containing automated chemistry tests may help labs offset the deep cuts. However, the loophole may also tempt some labs to develop custom panels to obtain higher reimbursement, and that could raise some serious compliance issues. Meanwhile, ACLA’s federal lawsuit is challenging the process by which CMS calculated new payment rates for lab tests paid through Medicare’s Clinical Laboratory Fee Schedule (CLFS).

A panel of distinguished lab experts was brought together for this interactive discussion of the most crucial issues and challenges facing the industry under Medicare’s market-based payment system. This webinar will show you how to:

  • Review how Medicare payments for high volume, molecular and proprietary tests will change during 2018-2020
  • Identify which labs are the biggest winners & losers under Medicare’s revised CLFS
  • Find out the latest word from CMS on advanced diagnostic laboratory tests (ADLTs)
  • Understand reimbursement and compliance problems with elimination of ATP payments and “gaming” of the system
  • Determine how uniform lab payment rates regardless of geography will work to the advantage of some states
  • Assess Medicare market-based pricing effects on Medicaid, Federal Employees Health Benefits, & private insurance payments
  • Obtain the latest status of ACLA’s lawsuit seeking that HHS publish a new rule including pricing data from all lab segments
  • Get answers to your specific questions about Medicare’s new lab payment approach


Medicare Market-Based Payment
Medicare’s Market-Based Payment Startup