{"id":8585,"date":"2024-09-27T09:59:00","date_gmt":"2024-09-27T14:59:00","guid":{"rendered":"https:\/\/www.appliedpolicy.com\/staging\/7403\/?p=8585"},"modified":"2024-11-24T22:31:23","modified_gmt":"2024-11-25T03:31:23","slug":"pama-implementation-delayed","status":"publish","type":"post","link":"https:\/\/www.appliedpolicy.com\/staging\/7403\/pama-implementation-delayed\/","title":{"rendered":"PAMA Implementation Delayed"},"content":{"rendered":"<p>Congress has once again delayed significant Medicare reimbursement cuts for clinical laboratory tests. Signed by President Biden on September 26, 2024, the <a href=\"https:\/\/www.congress.gov\/118\/bills\/hr9747\/BILLS-118hr9747eh.pdf\">short-term government funding bill<\/a> delays the implementation of up to 15% payment reductions for approximately 800 lab services by one year. This marks the fifth time Congress has postponed the phase-in of new payment rates for clinical laboratories under Section 216 of the <a href=\"https:\/\/www.govinfo.gov\/content\/pkg\/PLAW-113publ93\/pdf\/PLAW-113publ93.pdf\">Protecting Access to Medicare Act (PAMA) of 2014<\/a>.<\/p>\n<p>The American Clinical Laboratory Association (ACLA), a trade group whose members include Labcorp and Quest Diagnostics, called the delay \u201c<a href=\"https:\/\/www.acla.com\/acla-applauds-congressional-action-to-delay-medicare-cuts-urges-long-term-reform\/\">critically needed<\/a>\u201d to preserve patient access to many of the most commonly ordered lab tests. Despite the fact that legislation to reform reimbursement provisions under PAMA (e.g., <a href=\"https:\/\/www.congress.gov\/bill\/117th-congress\/senate-bill\/4449#:~:text=This%20bill%20modifies%20provisions%20relating,sampling%20of%20private%20sector%20rates.\">Saving Access to Laboratory Services Act (SALSA)<\/a>) failed to gain traction, the lab industry continues to push for sustainable Medicare lab test pricing solutions.<\/p>\n<p><strong>PAMA Background<\/strong><\/p>\n<p>PAMA, signed into law in 2014, originated because the Office of Inspector General determined that <a href=\"https:\/\/oig.hhs.gov\/documents\/evaluation\/3132\/OEI-09-15-00210-Complete%20Report.pdf\">Medicare payments for laboratory tests were often higher than payments for commercial payers<\/a>. The law\u2019s intent was to update the Medicare <a href=\"https:\/\/www.cms.gov\/medicare\/payment\/fee-schedules\/clinical-laboratory-fee-schedule-clfs\">Clinical Laboratory Fee Schedule (CLFS)<\/a> and create competitive, market-based laboratory testing prices.<\/p>\n<p>PAMA changed the way that Medicare calculates the CLFS, requiring that Medicare pay the weighted median rate of private payor payments for lab tests.<\/p>\n<p>Under PAMA, the first set of Medicare CLFS payment rates resulted in reimbursement cuts for many lab tests\u2014up to 10% each year for 2018, 2019, and 2020. Many commonly performed tests were reduced by 30% during this time.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Congress has once again delayed significant Medicare reimbursement cuts for clinical laboratory tests. Signed by President Biden on September 26, 2024, the short-term government funding bill delays the implementation of up to 15% payment reductions for approximately 800 lab services by one year. This marks the fifth time Congress has postponed the phase-in of new [&hellip;]<\/p>\n","protected":false},"author":19,"featured_media":7045,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","ap4_related_services":"","footnotes":""},"categories":[625],"tags":[],"class_list":["post-8585","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-diagnostics"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>PAMA Implementation Delayed - Applied Policy<\/title>\n<meta name=\"description\" content=\"Congress has postponed the phase-in of new payment rates for clinical laboratories under Protecting Access to Medicare Act (PAMA) of 2014.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"PAMA Implementation Delayed - Applied Policy\" \/>\n<meta property=\"og:description\" content=\"Congress has postponed the phase-in of new payment rates for clinical laboratories under Protecting Access to Medicare Act (PAMA) of 2014.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/\" \/>\n<meta property=\"og:site_name\" content=\"Applied Policy\" \/>\n<meta property=\"article:published_time\" content=\"2024-09-27T14:59:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-11-25T03:31:23+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.appliedpolicy.com\/wp-content\/uploads\/PAMA-delay.png\" \/>\n\t<meta property=\"og:image:width\" content=\"332\" \/>\n\t<meta property=\"og:image:height\" content=\"400\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Applied Policy\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Applied Policy\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/\"},\"author\":{\"name\":\"Applied Policy\",\"@id\":\"https:\\\/\\\/appliedpolicy.com\\\/#\\\/schema\\\/person\\\/326364c9511f087d2d72266f52773a49\"},\"headline\":\"PAMA Implementation Delayed\",\"datePublished\":\"2024-09-27T14:59:00+00:00\",\"dateModified\":\"2024-11-25T03:31:23+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/\"},\"wordCount\":249,\"image\":{\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.appliedpolicy.com\\\/staging\\\/7403\\\/wp-content\\\/uploads\\\/PAMA-delay.png\",\"articleSection\":[\"Diagnostics\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/\",\"url\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/\",\"name\":\"PAMA Implementation Delayed - Applied Policy\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/appliedpolicy.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.appliedpolicy.com\\\/staging\\\/7403\\\/wp-content\\\/uploads\\\/PAMA-delay.png\",\"datePublished\":\"2024-09-27T14:59:00+00:00\",\"dateModified\":\"2024-11-25T03:31:23+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/appliedpolicy.com\\\/#\\\/schema\\\/person\\\/326364c9511f087d2d72266f52773a49\"},\"description\":\"Congress has postponed the phase-in of new payment rates for clinical laboratories under Protecting Access to Medicare Act (PAMA) of 2014.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/#primaryimage\",\"url\":\"https:\\\/\\\/www.appliedpolicy.com\\\/staging\\\/7403\\\/wp-content\\\/uploads\\\/PAMA-delay.png\",\"contentUrl\":\"https:\\\/\\\/www.appliedpolicy.com\\\/staging\\\/7403\\\/wp-content\\\/uploads\\\/PAMA-delay.png\",\"width\":332,\"height\":400},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/pama-implementation-delayed\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/appliedpolicy.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"PAMA Implementation Delayed\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/appliedpolicy.com\\\/#website\",\"url\":\"https:\\\/\\\/appliedpolicy.com\\\/\",\"name\":\"Applied Policy\",\"description\":\"Health policy and reimbursement consulting\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/appliedpolicy.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/appliedpolicy.com\\\/#\\\/schema\\\/person\\\/326364c9511f087d2d72266f52773a49\",\"name\":\"Applied Policy\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/www.appliedpolicy.com\\\/staging\\\/7403\\\/wp-content\\\/uploads\\\/AP_Logo_icon_HiRes_rgb-1-300x300.jpg\",\"url\":\"https:\\\/\\\/www.appliedpolicy.com\\\/staging\\\/7403\\\/wp-content\\\/uploads\\\/AP_Logo_icon_HiRes_rgb-1-300x300.jpg\",\"contentUrl\":\"https:\\\/\\\/www.appliedpolicy.com\\\/staging\\\/7403\\\/wp-content\\\/uploads\\\/AP_Logo_icon_HiRes_rgb-1-300x300.jpg\",\"caption\":\"Applied Policy\"},\"url\":\"https:\\\/\\\/www.appliedpolicy.com\\\/staging\\\/7403\\\/author\\\/applied-policy-insight\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"PAMA Implementation Delayed - Applied Policy","description":"Congress has postponed the phase-in of new payment rates for clinical laboratories under Protecting Access to Medicare Act (PAMA) of 2014.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/","og_locale":"en_US","og_type":"article","og_title":"PAMA Implementation Delayed - Applied Policy","og_description":"Congress has postponed the phase-in of new payment rates for clinical laboratories under Protecting Access to Medicare Act (PAMA) of 2014.","og_url":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/","og_site_name":"Applied Policy","article_published_time":"2024-09-27T14:59:00+00:00","article_modified_time":"2024-11-25T03:31:23+00:00","og_image":[{"width":332,"height":400,"url":"https:\/\/www.appliedpolicy.com\/wp-content\/uploads\/PAMA-delay.png","type":"image\/png"}],"author":"Applied Policy","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Applied Policy","Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/#article","isPartOf":{"@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/"},"author":{"name":"Applied Policy","@id":"https:\/\/appliedpolicy.com\/#\/schema\/person\/326364c9511f087d2d72266f52773a49"},"headline":"PAMA Implementation Delayed","datePublished":"2024-09-27T14:59:00+00:00","dateModified":"2024-11-25T03:31:23+00:00","mainEntityOfPage":{"@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/"},"wordCount":249,"image":{"@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/#primaryimage"},"thumbnailUrl":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-content\/uploads\/PAMA-delay.png","articleSection":["Diagnostics"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/","url":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/","name":"PAMA Implementation Delayed - Applied Policy","isPartOf":{"@id":"https:\/\/appliedpolicy.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/#primaryimage"},"image":{"@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/#primaryimage"},"thumbnailUrl":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-content\/uploads\/PAMA-delay.png","datePublished":"2024-09-27T14:59:00+00:00","dateModified":"2024-11-25T03:31:23+00:00","author":{"@id":"https:\/\/appliedpolicy.com\/#\/schema\/person\/326364c9511f087d2d72266f52773a49"},"description":"Congress has postponed the phase-in of new payment rates for clinical laboratories under Protecting Access to Medicare Act (PAMA) of 2014.","breadcrumb":{"@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/#primaryimage","url":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-content\/uploads\/PAMA-delay.png","contentUrl":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-content\/uploads\/PAMA-delay.png","width":332,"height":400},{"@type":"BreadcrumbList","@id":"https:\/\/www.appliedpolicy.com\/pama-implementation-delayed\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/appliedpolicy.com\/"},{"@type":"ListItem","position":2,"name":"PAMA Implementation Delayed"}]},{"@type":"WebSite","@id":"https:\/\/appliedpolicy.com\/#website","url":"https:\/\/appliedpolicy.com\/","name":"Applied Policy","description":"Health policy and reimbursement consulting","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/appliedpolicy.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/appliedpolicy.com\/#\/schema\/person\/326364c9511f087d2d72266f52773a49","name":"Applied Policy","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-content\/uploads\/AP_Logo_icon_HiRes_rgb-1-300x300.jpg","url":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-content\/uploads\/AP_Logo_icon_HiRes_rgb-1-300x300.jpg","contentUrl":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-content\/uploads\/AP_Logo_icon_HiRes_rgb-1-300x300.jpg","caption":"Applied Policy"},"url":"https:\/\/www.appliedpolicy.com\/staging\/7403\/author\/applied-policy-insight\/"}]}},"_links":{"self":[{"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/posts\/8585","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/users\/19"}],"replies":[{"embeddable":true,"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/comments?post=8585"}],"version-history":[{"count":1,"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/posts\/8585\/revisions"}],"predecessor-version":[{"id":8586,"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/posts\/8585\/revisions\/8586"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/media\/7045"}],"wp:attachment":[{"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/media?parent=8585"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/categories?post=8585"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.appliedpolicy.com\/staging\/7403\/wp-json\/wp\/v2\/tags?post=8585"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}