Medicare`s New Market-Based Reimbursement System for Clinical Laboratory Testing: Tipping Point Ahead for U.S. Labs in 2018 covers topics such as:
- Overview of Medicare’s new lab payment system required by PAMA
- PAMA impact on local lab coverage decisions
- CMS regulatory timetable
- Definition of Applicable lab required to report data to CMS
- Projected Medicare savings under PAMA
- Lab data collection and reporting requirements
- Why most hospitals labs are excluded from providing data
- How new market-based rates are calculated
- Why less hospital lab data could result in higher reductions or all labs
- Phase-in of future payment reductions
- Which private payers are included in market-data approach
- Why payment changes under PAMA will impact Medicaid lab payments
- Illustrative example of maximum price reductions occur over 3 years
- Different reporting requirements for existing and new ADLTs
- Defining Advanced Diagnostic Laboratory Tests (ADLTs)
- Confidentiality issues surrounding lab data provided to CMS
- How to calculate existing and new ADLT payment rates
- Role of PAMA advisory panel
- Compliance mandates including certification and penalties
- What tests are projected to see biggest cuts under PAMA
- Options for calculating payments for lab panel payments
- Key OIG findings relating to PAMA implementation by CMS
- Identify test categories that may see higher payments
- Why PAMA’s market scheme may impact private payer rates
- Top remaining PAMA problems and concerns
Medicare`s New Market-Based Reimbursement System for Clinical Laboratory Testing: Tipping Point Ahead for U.S. Labs in 2018 intended for:
- CEOs
- Laboratory Presidents
- CIOs
- COO
- Senior Managers
- Administrative Directors
- Billing and Finance
- Head of Reimbursement
- Legal & Compliance Executives
