REIMBURSEMENT

CMS Enforcement Discretion Eases Pressure on Labs

After we went to press last month, the Centers for Medicare and Medicaid Services (CMS) announced just in the nick of time that it wouldn’t impose civil monetary penalties against labs which failed to meet the March 31, 2017 reporting deadline under the Protecting Access to Medicare Act (PAMA). That "enforcement discretion" will last until May 30, 2017. But, it also noted that this enforcement discretion doesn’t mean that those who are ready to report should delay their reporting until May 30.

CMS added that the 60-day enforcement discretion "is the maximum amount of time CMS can permit to still have sufficient time to calculate the CLFS payment rates scheduled to go into effect on Jan. 1, 2018." The agency explained its decision followed reports from the laboratory industry that some labs would have trouble reporting "a complete set of applicable information" in time for the March 31 deadline.

CMS acknowledged that some entities may need more time to collect and review their data, "address any issues identified during such review, and compile the data into CMS’s required reporting format."

In fact, just days earlier on March 24, various industry associations including the American Clinical Laboratory Association, National Independent Laboratory Association, College of American Pathologists and Clinical Laboratory Management Association had sent a letter to Health and Human Services Secretary Tom Price indicating many in the industry continued to struggle with the data collection requirements. That letter also reiterated industry concerns about the impact of the current definition of applicable laboratory and sought a one-year delay in implementation of PAMA.

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