OIG Watch

Agency to Review First Two Years of PAMA-Based Medicare Reimbursements for Lab Tests

As we pass the midpoint of the third year of the PAMA experiment—if that’s what it is—the OIG announced plans to review what happened in years one and two. One of the new items on the agency’s Work Plan for May is to analyze Part B lab test payments made under the 2018 Clinical Laboratory Fee Schedule (CLFS), the first year of PAMA-based Medicare reimbursement for lab tests. Specifically, the OIG will publish an analysis of the top 25 lab tests by expenditure for 2018. The June OIG Work plan provides for doing a similar analysis for 2019. So, stay tuned.