Thursday, March 30, 2017

CMS Extends Deadline to Submit PAMA Pricing by Two Months (May 30)

Note that technically, CMS is not "extending the deadline" but rather saying they will "not enforce late penalties" except for submissions that arrive after May 30.

60-Day Enforcement Discretion Period Announced for Laboratory Data Reporting

CMS Announces 60-Day Period of Enforcement Discretion for 
Reporting Applicable Information Under the 
Medicare Clinical Laboratory Fee Schedule

Today, the Centers for Medicare & Medicaid Services’ Center for Medicare (CM) announced that it will exercise enforcement discretion until May 30, 2017, with respect to the data reporting period for reporting applicable information under the Medicare Clinical Laboratory Fee Schedule (CLFS) and the application of the Secretary’s potential assessment of civil monetary penalties (CMPs) for failure to report applicable information. This enforcement discretion applies to entities that are subject to the data reporting requirements adopted in the Medicare Clinical Diagnostic Laboratory Tests Payment System final rule published on June 23, 2016 (81 FR 41036).

Industry feedback suggests that many reporting entities will not be able to submit a complete set of applicable information to CMS by the March 31, 2017 deadline, and that such entities require additional time to review collected data, address any issues identified during such review, and compile the data into CMS’s required reporting format. This 60-day enforcement discretion period is the maximum amount of time CMS can permit to still have sufficient time to calculate the CLFS payment rates scheduled to go into effect on January 1, 2018.

This enforcement discretion period does not prevent reporting entities prepared to report applicable information from doing so before May 30, 2017. CMS is committed to the successful implementation of the new private payor rate-based CLFS and looks forward to working with the laboratory industry to ensure accurate payment rates. CMS will continue to closely monitor this process and provide guidance as necessary.