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August 16, 2016
Medicare Releases List of Codes Subject to Data Reporting Under PAMA
The Centers for Medicare & Medicaid Services (CMS) has published a list of HCPCS codes for clinical laboratory tests that applicable laboratories will use to collect and report private payer data to the CMS.
The Protecting Access to Medicare Act (PAMA) of 2014 requires applicable laboratories to collect and report private payer rates for lab tests to the CMS, which will use the data to calculate Medicare payment rates for clinical laboratory tests. The timeframes for data collection and reporting is the same as what was listed in the final PAMA regulation published on June 17. The first data collection period for applicable laboratories is from January 1, 2016, through June 30, 2016, with data reporting taking place from January 1, 2017, through March 31, 2017.
A ZIP file with the applicable HCPCS codes subject to data collection and reporting is available for download from the CMS website.
The CAP has engaged and shared several concerns with the CMS and other stakeholders on the implementation of changes to the clinical laboratory fee schedule (CLFS) that are required by PAMA. The CAP has also advocated for clarity and administrative ease in reporting of data.
The CAP will continue to keep its members updated on PAMA's implementation through STATLINE.
Pathology Payment Updates: Reserve Your Seat for Advocacy Courses at CAP16
Registration is now open for key CAP policy and advocacy courses and roundtable discussions important to the pathology specialty during CAP16 in Las Vegas September 25-28.
Ensure you can attend "MACRA, Pay for Performance and the Physician Fee Schedule—You Can Run But You Can't Hide" (S1620) by registering and selecting this popular course today. Enactment of the Medicare Access and CHIP Reauthorization Act (MACRA) will change how all physicians are paid under Medicare. Make sure to attend this course and learn about this game changing mandatory Medicare physician payment system. Measurement periods begin in 2017 so register now so that you are ready for these changed to Medicare's physician reimbursement system.
During this featured presentation, attendees will learn the purpose of new pay-for-performance programs and delivery system reform culminating in the enactment and implementation of MACRA. Experts will explain which pathologists are subject to, and ways to successfully participate in, the merit-based incentive payment system and alternative payment model pathways. The potential ramifications for not participating will also be discussed.
The session starts at 8 AM on Monday, September 26. Register for S1620 MACRA, "Pay for Performance and the Physician Fee Schedule—You Can Run But You Can't Hide" today.
Additional CAP advocacy courses and roundtable discussions are also available at CAP16:
- M1597 How is My Payment Determined for Pathology Services?
Sunday, September 25, 4:30-5:30 PM
- R1690 My Surgical Pathology and Cytopathology Coding Dilemmas: Getting It Right
Monday, September 26, Noon-1 PM
- STA001 "How Data Drives CAP Advocacy: What Pathologists are Saying about the Economics of Pathology Practice"
Monday, September 26, 5:30-6:30 PM
- R1691 Current Payment Policy Challenges in Pathology Practice
Tuesday, September 27, Noon-1 PM
HHS Awards $4.1 million to Laboratory for Zika Screening Test
The US Department of Health and Human Services (HHS) announced on August 9 an agreement with a Massachusetts laboratory to develop a blood screening test that detects the presence of Zika in the blood supply.
In 2016, HHS has repurposed $374 million for domestic Zika response and preparedness activities. The funding includes $41.4 million to develop vaccines, diagnostics, blood screening tests, and pathogen reduction technologies through private sector partnerships.
Hologic, Inc. of Marlborough, MA, was awarded $4.1 million to develop the Zika test, according to the August 9 HHS announcement. The award from the HHS Office of the Assistant Secretary for Preparedness and Response is the second for a screening test for donated blood. In April, HHS announced its support of a clinical study of a Zika blood screening test developed by Roche Molecular Systems, Inc. of Branchburg, NJ, to confirm whether the test accurately detects the virus in donor blood.
Last Chance to Take Our STATLINE Readership Survey
The CAP invites STATLINE readers to take a quick study regarding STATLINE, our weekly federal and state advocacy e-newsletter. STATLINE, a CAP-member benefit, provides information on policy, legislation, and political action as well as economic and regulatory affairs that affect pathology and laboratory medicine. Your valuable feedback will allow us to evaluate and improve the e-newsletter to best meet your needs. This survey should take approximately 5-10 minutes to complete.
Take the STATLINE Readership Survey.
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