CMS Proposes Overhaul of Clinical Lab Payment Methodology: What You Need To Know

Polsinelli
Contact

On Friday, the Centers for Medicare & Medicaid Services (“CMS”) issued a long-awaited proposed rule that would drastically change the payment rates for clinical laboratory services beginning January 1, 2017 (the “Proposed Rule”). As mandated by Congress under the Protecting Access to Medicare Act of 2014 (“PAMA”), the Proposed Rule would require “applicable laboratories” to report payment rates received from private insurers and would base the new Medicare payment amounts on a weighted median of those rates. CMS expects this to result in a $360 million pay cut for laboratories in 2017 alone and potential savings for Medicare of over $2.94 billion over the next five years.

The rule will be formally published in the Federal Register on October 1; until then, it is accessible in display copy here. Comments are due by November 24, 2015.

Please see full Publication below for more information.

LOADING PDF: If there are any problems, click here to download the file.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Polsinelli | Attorney Advertising

Written by:

Polsinelli
Contact
more
less

Polsinelli on:

Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Custom Email Digest
- hide
- hide

This website uses cookies to improve user experience, track anonymous site usage, store authorization tokens and permit sharing on social media networks. By continuing to browse this website you accept the use of cookies. Click here to read more about how we use cookies.