Groups urge CMS to suspend draft laboratory payment rates under PAMA

Twenty-three organizations, including the AHA, Friday urged the Centers for Medicare & Medicaid Services to suspend implementation of new draft Medicare clinical laboratory fee schedule payment rates under the Protecting Access to Medicare Act of 2014, citing significant concerns with the data collection process used to establish the rates. CMS intends to begin using the new laboratory test payment rates on Jan. 1, 2018. “The data sources used to determine the preliminary rates do not appear to reflect the various market segments, which CMS has the authority to consider in order to validate the data submitted,” the organizations wrote. “It is also clear from our review that the overly burdensome regulatory requirements resulted in the submission of inaccurate and incomplete laboratory payment data that is not reliable for use in its current form.” The groups urged CMS to “take swift action to engage in a constructive dialogue with stakeholders on ways to improve the PAMA data process and calculation, and establish a clear path forward for the clinical laboratory community and the Medicare beneficiaries who rely on its services.”