Monday, November 16, 2015

30 Slide Deck on PAMA - the New Lab Test Pricing Law

In October, BIO invited me to provide a webinar on PAMA, the law that will eventually create a new pricing system for laboratory tests in 2017 or 2018.

The deck is in the cloud, here.

The executive summary is here:

  • Awareness that CMS lab fee schedules exceeded US market prices led to PAMA §216 in April 2015.
  • In a massive undertaking, laboratories will report all payer prices for all tests.  The medians will establish new triennial CMS fee schedules.
  • CMS released its implementation plans on 9/25/2015, and comment is open until 11/24/2015.

The outline for the flow of the deck is here:

Which Labs Will Report?
What Will They Report?
   Catchment Period
   Reporting Period
What Happens Next?
   Median Calculation
   3 Year Repeat
Special Rules?
   What are ADLTs?   How They Report?
New Tests?
Advisory Board?

View or download the deck here.