CodeMap® Compliance Briefing: October 2, 2019
Editor's Welcome: In 2014, Congress passed the Protecting Access to Medicare Act (PAMA) and CMS was directed by Congress to establish market-based rates for clinical laboratory services. Market-based is another term for payment rates paid by commercial, private insurers. Over the past two years, laboratory associations and stakeholders have urged CMS to include more data from hospitals and physician office laboratories in order to get a more accurate representation of the full clinical laboratory market. A bill has been introduced, the LAB Act, which seeks to address some of these issues. However, it remains to be seen if bipartisan attention and support can be garnered to pass this legislation in time to do any good.
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