Prepping for PAMA: Understanding the new law and its impact on your lab
Kate Claessens MS, BSN, RN
Senior Director of Policy and Reimbursement
With the recent passage of the new law, the Protecting Access to Medicare Act of 2014 (PAMA), major changes loom on the horizon that are set to disrupt the fiscal landscape of clinical lab testing as we know it today.
Under Medicare’s Clinical Laboratory Fee Schedule (CLFS), payment rates will all be reset based on rates paid by private insurers. While not scheduled to go into effect until January 2017, all applicable laboratories will soon be asked to report private payer rates and volumes on any CLFS tests they provide to the Centers for Medicare and Medicaid Services (CMS).
CMS has recently issued a proposed rule that will, when finalized, implement the PAMA provision, but the Agency has yet to provide any detailed guidance for labs to follow in order to adopt these changes and be compliant in reporting their data.
In an effort to help you gain a better understanding of the full impact of the PAMA provision, and what you’ll be required to do, LabLeaders.com engaged Kate Claessens MS, BSN, RN, Senior Director of Health Policy and Reimbursement, Roche Diagnostics, to shed some light about what’s currently known and what’s still unclear about these upcoming changes.
Get answers to pressing questions about what your lab is required to do
We would like to extend a special thank you to our LabLeaders members for submitting questions to Kate Claessens regarding this very important topic. We invite you to submit inquiries on other market forces you would like insight on by clicking CONNECT on LabLeaders.com.