Potentially thousands of additional clinical laboratories are now considered to be "applicable laboratories" which are required to collect private payer data for a six month period starting January 1 under revised regulations finalized by CMS as part of the Protecting Access to Medicare Act (PAMA).
Even as labs nationwide experience more financial pain as the second year of PAMA cuts take effect, plus start to feel the impact of any rate reductions imposed by commercial payers, they must also be alert to their status under PAMA and if required, begin collecting private payer data during the first half of 2019 and report it to CMS during the first three months of 2020. Failure to report could subject offending labs to civil monetary penalties of up to $10,000 per day.
This session will present up-to-the-minute instructions from CMS on data collection requirements plus interpretative guidance including the definition of "non-patient" for the purposes of determining private payer rates hospital labs must report. Get the lowdown on what affected labs must do to comply, peer advice for hospital executives and detailed answers by our experts to all your questions.
Here's just a sample of critical questions we'll tackle as part of this "must-attend" 75-minute interactive session:
What's the revised definition of 'applicable laboratory' used by CMS to increase the number of labs required to report private payer data?How can your lab determine whether it's required to collect & report data?What is the latest guidance from CMS regarding the clinical laboratory fee schedule data reporting system process?Has CMS defined 'non-patient' for purposes of determining private payer rates that hospital labs must report?What are some of the technical problems labs are liable to encounter in collecting private payer data?Does my lab have to collect data if we bill using the 13X bill type rather than the 14X?Will CMS penalize labs required to collect & report data under PAMA, but who fail to do so?Based on the first round of data collection and reporting experience under PAMA, what's the best practical advice for labs going forward?
Where can I find the best resources for gaining more information about what's required in collecting and reporting data to CMS?
Featured XIFIN Speaker
Executive Chairman & CEO
VP Business & Operational Performance
Northwell Health Labs