08/22/2018: OIG Report on PAMA Implementation

CodeMap® Compliance Briefing: August 22, 2018


Editor's Welcome: Almost all laboratory professionals know by now that the Protecting Access to Medicare Act of 2014 significantly reduced Medicare reimbursement for a majority of tests and procedures listed on the Medicare Clinical Laboratory Fee Schedule (CLFS). PAMA also requires the Office of Inspector General (OIG) to periodically conduct analysis and make reports concerning how well the federal government, through the Centers for Medicare and Medicaid Services (CMS), has implemented PAMA and the resultant payment system. Last month, the OIG issued its second report concerning CMS' implementation of PAMA. The report details CMS' implementation of PAMA, describes the new payment rates included in the CLFS since January 2018, and identifies several interesting challenges and risks experienced by CMS during the implementation process. This....

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