Don't Let CMS Create Skewed Payment Rates
ASCP is continuing an eAdvocacy campaign to encourage the Centers for Medicare and Medicaid Services (CMS) to change its pricing strategy and implementation timeline to reprice the entire Clinical Laboratory Fee Schedule (CLFS). The Protecting Access to Medicare Act (PAMA) required CMS to finalize regulations, by June 30, 2015, outlining the requirement for clinical laboratories to submit data on the pricing they receive for laboratory services and the corresponding test volume. CMS released a Notice of Proposed Rulemaking (NPRM) on September 25, 2015; final rules have not been released.
The issues ASCP is addressing relate to two proposals: (1) the Agency’s plans to exempt hospital laboratory data from the median price the agency will calculate from the data it receives, and (2) the proposed timeline. Given that hospital laboratories typically receive higher payment rates than other laboratories, CMS’ approach could result in insufficient payment rates that could shutter some small- and medium-sized laboratories. Participants in the ASCP eAdvocacy campaign will be asking CMS to include hospital laboratory data in the campaign. In addition, ASCP is urging that the final timeline set by the Agency would require data reporting no sooner than January 1, 2017 (and last at least 3 months) to give laboratories sufficient time to configure and test their reporting systems. To send a message to your representatives in Congress and officials at CMS, please use the following link for the ASCP eAdvocacy Center. ...