Affordable Care Act ñ Section 3113 ñ Laboratory Demonstration for Certain Complex Diagnostic Tests

Section 3113 of the Affordable Care Act requires CMS to conduct a demonstration project for certain complex diagnostic laboratory tests for a period of 2 years beginning July 1, 2011, or until the one hundred million dollar ($100,000,000) payment ceiling established for the demonstration has been reached. The demonstration will establish a separate payment method for the demonstration tests with a Date of Service (DOS) that would, under standard Medicare rules, be bundled into the payment for an associated hospital inpatient stay. Under the demonstration, independent and hospital-based laboratories may bill separately for demonstration tests that are ordered within a 14 day period after a hospital discharge.

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