May 5, 2014 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
“Protecting Access to Medicare Act of 2014” requires most medical laboratories to report market data and allows Medicare officials cut prices of Part B lab tests beginning in 2017
NEW ORLEANS, LA—No single development in the clinical laboratory industry grabbed more attention last week at the Executive War College than news that a new federal law gives Medicare officials the ability to reduce prices of individual medical laboratory tests by as much as 75% between 2017 and 2022.
This law is titled the “Protecting Access to Medicare Act of 2014” (PAMA). Congress passed this legislation to patch the Sustainable Growth Rate (SGR) formula until April 2015. (more…)
May 2, 2014 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
Medical laboratories and anatomic pathology groups are scrambling to respond as healthcare evolves into new models of integrated clinical care and payers seek to reduce reimbursement for clinical lab tests
NEW ORLEANS, LA.—There was more bad news than good news for the 800 clinical laboratory professionals and pathologists who assembled this week in “The Big Easy” to discuss and debate the serious financial and clinical challenges now weighing down the entire profession of laboratory medicine in the United States.
Probably the most unwelcome news delivered to attendees at the 19th Annual Executive War College on Laboratory and Pathology Management, was the contents of the new law titled the “Protecting Access to Medicare Act of 2014” (PAMA). This was the legislation passed by Congress to patch the Sustainable Growth Rate (SGR) formula for one more year. It was signed into law by President Obama on April 1, 2014. (more…)
Apr 14, 2014 | Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
Leaders from ACLA, AdvaMedDx, CAP, NILA will be at Executive War College on April 29-30 for first medical lab industry debate about the best and worst of the new law
Clinical laboratories will face new financial challenges following passage of a new federal law two weeks ago that makes deep changes in the way Medicare officials will establish prices for the Medicare Part B Clinical Laboratory Fee Schedule (CLFS). Many medical laboratory administrators, hospital lab managers, and pathologists remain unaware of the significant negative financial impact this law will have on their lab’s revenue and fiscal stability.
On April 1, President Barack Obama signed H.R. 4302: Protecting Access to Medicare Act of 2014. The law’s primary purpose is to extend the Sustainable Growth Rate (SGR) formula for 12 months. The House had passed the bill on the previous Thursday and the Senate passed the bill on the following Monday, March 31. (more…)
May 1, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement, Management & Operations
For more than a year Medicare contractors have been developing payment rates for the 114 molecular tests and without setting rates, they cannot make payments.
New Orleans, Louisiana, April 30, 2013—Getting paid for molecular test claims submitted under the new molecular CPT codes was a subject of high interest on the opening day of the Executive War College. Most clinical laboratories and pathology groups performing molecular tests nationwide report that they have not been paid for invoices submitted to Medicare contractors since January 1, 2013.
Several sessions were devoted to this important topic. Medicare contractors nationwide have not paid many of the molecular diagnostic test claims submitted since January 1 according to speakers and attendees at the first day of The Dark Report’s 18th Annual Executive War College in New Orleans. (more…)
Jul 1, 2011 | Laboratory Pathology
Proposed repeal rule was published in yesterday’s Federal Register
Yesterday, pathologists and clinical laboratory managers got an early Fourth of July present. That’s because the federal Centers for Medicare and Medicaid Services (CMS) published the proposed rule that repeals the requirement that paper requisitions for medical laboratory tests must have the physician’s signature.
This rule had been mandated by the 2011 Medicare Physician Fee Schedule Rule that was to take effect on January 1, 2011. In response to the negative response to this rule from important sectors of healthcare, including laboratory medicine professionals, hospital groups, and physician associations, as well as both Houses of Congress, CMS deferred implementation of the rule for the first 90 days of 2011. (See Dark Daily, “Good News for Clinical Laboratories as CMS Delays Physician’s Signature Requirement, December 22, 2010.”
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