How will the new payment rate reporting requirements impact your business? Effective January 1, 2017, Medicare will pay for most clinical laboratory tests using the weighted median of payments labs receive from other payers, as mandated by Section 216 of the Protecting Access to Medicare Act of 2014 (PAMA). Beginning January 1, 2016, each “applicable laboratory” must report the payment amount and volume of each test paid by each private payer, Medicare Advantage plan, and Medicaid managed care plan. Failure to comply with the reporting requirements may result in a civil money penalty of up to $10,000 per day.
CMS was required by statute to finalize a regulation defining many aspects of the reporting process by June 30, 2015. The proposed rule addresses key questions such as:
- Which laboratories are “applicable laboratories”?
- Which tests will qualify for special payment rules?
- How will new tests receive codes, coverage, and payment?
Join Arnold & Porter LLP and XIFIN, Inc. for a 90-minute webinar that will discuss the proposed rule's answers to these questions and more. This webinar will provide an opportunity to understand how the regulatory landscape is changing, the opportunities and challenges facing laboratories, and what you can do to ensure compliance.
Paul M. Rudolf MD, Partner, Arnold & Porter, Washington, DC
Thomas A. Gustafson PhD, Senior Policy Advisor, Arnold & Porter, Washington, DC
Jennifer B. Madsen MPH, Health Policy Advisor, Arnold & Porter,
Kristin M. Hicks JD, Associate, Arnold & Porter, Washington, DC
Rina Wolf, MHA, Vice President, XIFIN, Inc.
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1.5 hours of CA MCLE credit is pending.
CLE credit for other jurisdictions is also pending.