Protecting Access to Medicare Act
Signed into law on April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) includes the most extensive reform of the Medicare Clinical Laboratory Fee Schedule (CLFS) since it was established in 1984. Section 216 of PAMA creates a new Section 1834A of the Social Security Act, which contains many of the CLFS…
Signed into law on April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) includes the most extensive reform of the Medicare Clinical Laboratory Fee Schedule (CLFS) since it was established in 1984. Section 216 of PAMA creates a new Section 1834A of the Social Security Act, which contains many of the CLFS reforms. Starting on January 1, 2017, most rates on the CLFS will be derived from private payor rates for laboratory services. PAMA also designates certain tests as “advanced diagnostic laboratory tests” (ADLTs); includes provisions affecting coding, coverage and oversight of the CLFS; and makes some changes to CMS’s review of mis-valued codes in the Physician Fee Schedule (PFS) affecting anatomic pathology services provided by laboratories.
The Centers for Medicare and Medicaid Services (CMS) is working on rules to implement these provisions. In particular, CMS must finalize rules by June 30, 2015 that explain how the agency will collect private market data and set new CLFS rates. ACLA is working with the agency, our laboratory membership, and other lab industry stakeholders to ensure that the rules result in a workable and transparent process and fee schedule that ensure adequate patient access to the highest quality clinical laboratory services and that enable physicians and patients to lower costs and achieve higher quality health care outcomes.
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ACLA Letter on Medicare Program to Ways and Means Health Subcommittee
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ACLA Commends CMS’ Decision to Exercise Enforcement Discretion for Reporting Applicable Information Under PAMA
(Washington, D.C.) – The American Clinical Laboratory Association (ACLA) today lauded the decision by the Centers for Medicare and Medicaid Services (CMS) to exercise enforcement discretion until May 30, 2017 for laboratories reporting private payor pricing data as required by the Protecting Access to Medicare Act (PAMA). “ACLA appreciates the decision by CMS to exercise enforcement discretion until May 30, 2017,” said Julie Khani,Continue Reading »... -
Clinical Laboratories, Laboratory Professionals, Physicians Urge HHS to Delay PAMA Implementation
– Challenges with Data Reporting Requirements, Problems with CMS Reporting Portal Cause Rate Calculation Integrity Concerns; Threaten to Reduce Clinical Lab Infrastructure and Limit Patient Access to Vital Laboratory Test Services – WASHINGTON, D.C. – Ten organizations representing a diverse cross section of the clinical laboratory community – including the American Clinical Laboratory Association – today sent a joint letter to U.S. Department ofContinue Reading »... -
ACLA Letter to HHS Secretary Tom Price About Implementation of the Medicare Clinical Laboratory Fee Schedule (CLFS) Reform as Enacted by Section 216 of the Protecting Access to Medicare Act of 2014 (PAMA).
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ACLA Reviewing HHS OIG Reports on Implementation of CLFS Reform
(WASHINGTON, DC) – American Clinical Laboratory Association (ACLA) President Alan Mertz issued the following statement today regarding the reports released by the Department of Health and Human Services Office of Inspector General (OIG) on Medicare payments for laboratory tests, and the status of efforts by the Centers for Medicare & Medicaid Services (CMS) to implement market based payment reform as called for by theContinue Reading »... -
ACLA Commends Senate Effort to Combat Proposed Gapfill Measures, Protect Medicare Patient Access to Advanced Diagnostic Tests
WASHINGTON, D.C. – The American Clinical Laboratory Association (ACLA) today applauded the patient advocacy efforts of Sen. Richard Burr (R-NC), Sen. Michael Bennet (D-CO) and other U.S. Senators who penned a bipartisan public letter to the Centers for Medicare & Medicaid Services (CMS), cautioning CMS against proposed rate cuts for necessary diagnostic tests. Earlier this year, CMS unveiled its 2016 Preliminary Gapfill Payment Determinations.Continue Reading »... -
Letter to CMS on the Preliminary Gapfill Payment Determinations
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Medicare Part B Clinical Laboratory Fee Schedule: Guidance to Laboratories for Collecting and Reporting Data for the Private Payor Rate-Based Payment System
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ACLA Applauds CMS Decision to Delay New Payment System, Evaluating Final PAMA Rule
(WASHINGTON, DC) –The American Clinical Laboratory Association (ACLA) – the nation’s largest organization representing the public policy interests of clinical laboratories — is reviewing the final rule released today by the Centers for Medicare and Medicaid Services (CMS) to implement the Clinical Laboratory Fee Schedule (CLFS) provisions of the Protecting Access to Medicare Act (PAMA). ACLA commended CMS on its decision to delay theContinue Reading »... -
ACLA Commends Chairman Tiberi, Reps. Pascrell and Meehan for Bipartisan House Ways and Means Committee Letter to CMS Calling for PAMA Implementation Delay
WASHINGTON, D.C. – The American Clinical Laboratory Association (ACLA) today applauded House Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH), and his Ways and Means colleagues Bill Pascrell (D-NJ) and Pat Meehan (R-PA), along with 24 other committee members, for sending a bipartisan letter to Andy Slavitt, Acting Administrator for the Centers for Medicare & Medicaid Services (CMS), urging CMS to delay implementationContinue Reading »...
