After years of rule-making and private payer data collection/submission in accord with the 2014 Protecting Access to Medicare Act (PAMA), CMS finally released on Sept. 22 preliminary payment amounts for laboratory tests to be paid under a new market-based Clinical Laboratory Fee Schedule (CLFS). Following a 30-day comment period, CMS intends to publish final payment rates this November for implementation starting January 1, 2018.
Featured XIFIN Speaker
Executive Chairman & CEO
Thomas Hirsch, President, Laboratory Billing Solutions
Dennis Weissman, President, Dennis Weissman & Associates, LLC
Julie Khani, President, American Clinical Laboratory Association
Here’s the bottom line: for about three quarters of all codes on the CLFS, the weighted median of the private-payer rates show a decrease over current payment rates whereas only 10% would result in an increase. Significantly, CMS claims that its proposed changes in lab prices would save Medicare Part B a whopping $670 million in calendar-year 2018 alone.
This webinar addresses the most critical issues for lab and pathology interests:
Find out how Medicare rates for high-volume tests will change in 2018Determine how higher-priced payments for genetic & molecular tests will fare under the new market-based Clinical Laboratory Fee ScheduleDiscover which tests registered the largest reductions and those that recorded the highest increases under the preliminary pricing schemeUnderstand how CMS is handling pricing for those test codes with insufficient private payor payment data availableWeigh what the agency says the impact would be on projected CLFS spending if it had used more reporting data from hospital labsIdentify top industry concerns surrounding CMS’s decision to move ahead with its market-based CLFS starting in January 2018Discuss how different lab settings, including hospital outreach and community labs, will be affected by Medicare’s new payment approach
Explain the process for commenting on proposed PAMA market-based payment rates and its likely impact on final CMS pricing decisions