It wasn’t supposed to happen like this. The expectation was that the new PAMA market-based pricing system was going to save Medicare 10 percent or more on lab test reimbursements. But it hasn’t … [Read more...]
OIG Reports that 2018 Medicare Part B Lab Test Spending Increased Despite PAMA Cuts
Three key items to negotiate for successful payer contracts
By Steve Selbst bio The purpose of this article is to help you, as a provider, to focus on three key items to look for in payer contracts that will help you to get profitable contracts in … [Read more...]
PAMA Unlocks Golden Age for Innovative Diagnostics
By Chance Scott bio The publication of the 2018 Clinical Laboratory Fee Schedule (CLFS) in January saw a long and heated debate within the lab community come to fruition. When Congress … [Read more...]
How PAMA’s Effect in 2018 Molecular Diagnostic Reimbursement Will Make Labs More Money
By Sean McSweeney bio The year 2018 is slated to be much brighter for molecular diagnostic labs as PAMA fee schedules show a higher payment rate and amount for many cancer genomics and … [Read more...]
Industry Buzz: ACLA Goes for Kill in PAMA Lab Fees Challenge Case
Attorneys for the American Clinical Laboratory Association asked the federal court for summary judgment in its lawsuit challenging the legality of the new PAMA-based Medicare Part B fee schedule for … [Read more...]
CMS Ignores Flawed Processes, Finalizes 2018 PAMA Pricing; Labs Need to Take Immediate Action to Offset Impending Lean Times
By Kyle Fetter bio The final 2018 clinical laboratory fee schedule (CLFS) is out, and it is evident that the argument that the Centers for Medicare & Medicaid Services (CMS) PAMA … [Read more...]
OPPS 2018: Revised Payment Rates & a New ADLT Date of Service Exemption
With all of the PAMA commotion, CMS's publication of the 2018 Medicare Hospital and Ambulatory Surgical Outpatient Prospective Payment System (OPPS) final rule has flown under the radar. In case you … [Read more...]
PAMA-Geddon: CMS Slashes 2018 Part B Lab Rates
Resisting industry pleas for a delay, CMS is sticking to the Jan. 1 start date for the new PAMA payment system. Even worse, it's sticking to its misguided formula for pricing lab tests. Result: The … [Read more...]
“Applicable Labs”: The Fly in the PAMA Market-Based Pricing Ointment
The lab industry has no objection to basing Medicare payments for lab tests on the actual rates charged to payors in the private market. What has the industry so upset is how CMS has executed the … [Read more...]
Draft 2018 CLFS Reveals Fundamental Flaws in PAMA Reporting Exercise; Time to Take Action
By Lâle White bio As XIFIN predicted, the PAMA reporting exercise has resulted in significant proposed laboratory fee cuts. In fact, the multi-year decrease for the top 20 laboratory tests … [Read more...]