CMS posted PAMA Regulation Rates

CMS has published the preliminary payment rates and supporting documentation for the new private payor rate-based CLFS payment system.  These rates will be implemented on January 1, 2018. CMS’s  initial prices for clinical lab tests issued under PAMA would save the government payor around $670 million, shaving nearly 10 percent off the $7 billion that it pays annually for lab tests. CMS previously estimated that using a market-based system stipulated under PAMA would save $390 million in the first year of 2018, and $3.93 billion over a decade. The deeper proposed cuts, slated to go into effect in January, didn't sit well with the American Clinical Laboratory Association. Industry players have a month to comment on the draft prices and make their case to CMS for any changes before final prices are released in November. "If these draft rates were finalized, the impact would be devastating," said ACLA President Julie Khani. "We fear the impact on laboratories serving the most vulnerable Medicare beneficiaries, laboratories serving rural areas, and those with high Medicare volumes would be the most severely impacted." She added that the association is working to halt the finalization and implementation of these "flawed and inaccurate" rates. CMS will accept public comments on the preliminary determinations until October 23, 2017.  Comments must be submitted electronically by this date to the following CMS mailbox:


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