Webinar: Sizing Up PAMA’s Preliminary 2018 Payment Rates: What’s the Bottom Line For Your Lab?

After years of rule-making and private payer data collection/submission in accord with the 2014 Protecting Access to Medicare Act (PAMA), CMS finally released on Sept. 22 preliminary payment amounts for laboratory tests to be paid under a new market-based Clinical Laboratory Fee Schedule (CLFS). Following a 30-day comment period, CMS intends to publish final payment rates this November for implementation starting January 1, 2018.

Featured XiFin Speaker

Lâle White
Executive Chairman & CEO
XiFin, Inc.

Additional Speakers:

Thomas Hirsch, President, Laboratory Billing Solutions
Dennis Weissman, President, Dennis Weissman & Associates, LLC
Julie Khani, President, American Clinical Laboratory Association

Here’s the bottom line: for about three quarters of all codes on the CLFS, the weighted median of the private-payer rates show a decrease over current payment rates whereas only 10% would result in an increase. Significantly, CMS claims that its proposed changes in lab prices would save Medicare Part B a whopping $670 million in calendar-year 2018 alone.

This webinar addresses the most critical issues for lab and pathology interests:

• Find out how Medicare rates for high-volume tests will change in 2018
• Determine how higher-priced payments for genetic & molecular tests will fare under the new market-based Clinical Laboratory Fee Schedule
• Discover which tests registered the largest reductions and those that recorded the highest increases under the preliminary pricing scheme
• Understand how CMS is handling pricing for those test codes with insufficient private payor payment data available
• Weigh what the agency says the impact would be on projected CLFS spending if it had used more reporting data from hospital labs
• Identify top industry concerns surrounding CMS’s decision to move ahead with its market-based CLFS starting in January 2018
• Discuss how different lab settings, including hospital outreach and community labs, will be affected by Medicare’s new payment approach
• Explain the process for commenting on proposed PAMA market-based payment rates and its likely impact on final CMS pricing decisions