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Citing Private Payor Data, CMS Cuts Reimbursement for 75% of Lab Tests in 2018

Late Friday evening, the Centers for Medicare & Medicaid Services (CMS) released their long-awaited preliminary private rate-based clinical laboratory fee schedule rates. These rates begin to implement section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA) by establishing new clinical laboratory fee schedule (CLFS) payment rates for diagnostic tests paid by Medicare […]

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CMS’ CLFS Panel Hears Suggestions for New Test Pricing; Concerns About PAMA

On July 31 and August 1, CMS held its Annual Laboratory Public Meeting to hear public consultation on coding and payment for new and reconsidered clinical diagnostic laboratory tests. For two days, the Advisory Panel heard and discussed presentations justifying crosswalked and gap-filled prices for new and reconsidered laboratory tests. Echoing the concerns of stakeholders […]

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CMS Proposes Minor Increase to Physician Fee Schedule and Delays to Diabetes Prevention Program; Appears Willing to Reconsider Biosimilar Payments

On July 13, 2017, the Centers for Medicare and Medicaid Services (CMS) released the Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2018 proposed rule. The proposed rule updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule on […]

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