Hospital outreach laboratories which escaped providing private payor data to Uncle Sam under The Protecting Access to Medicare Act (PAMA) during the first round of reporting in 2016 have now run out of luck as the next collection period starts this January and runs through June 30, 2019.
That’s because CMS has revised the definition of “applicable laboratoryâ€ which now encompasses most hospital outreach labs.
But a recent survey by Quest Diagnostics and Modern Healthcare Custom Media found that many hospitals are not even aware of PAMA and unprepared to mitigate its impact, including being subject to civil monetary penalties for those labs required to report data but failing to do so.
PAMA imposed reimbursement cuts for some 75% of lab tests billed to Medicare in 2018, taking nearly $670 million from labs in that year alone or about a 10% decrease from the previous fee schedule. A similar 10% cut for many tests is set to follow both in 2019 and 2020.
For the latest guidance from CMS and expert advice on what labs must do to comply with the PAMA data collection requirement, join me for a new national webinar I’m chairing on January 15 from 2:00 – 3:15 pm ET. The interactive program, Next PAMA Data Collection Period Starts in January: The Nitty Gritty on Labs Affected & Whatâ€™s Required, will feature several PAMA experts to answer all your questions, For program details and registration information, visit laboratoryeconomics.com or call 1-845-463-0080.