Medical Labs Sue Over Reductions In Medicare Payments
The trade association that represents clinical labs says the administration is misapplying a 2014 law that sought to set market-based pricing for certain lab tests.
Tired Of Talking, Labs Sue CMS Over Planned Cut
Clinical labs are suing the CMS over a planned multibillion-dollar cut to their reimbursement. They expect to lose $670 million next year as part of a CMS effort to pay the same rate for tests as private payers. Medicare's fee schedule for lab tests has been largely unchanged since it was established in 1984. Each lab determines its own rates based on market prices. Medicare has historically paid 18% to 30% more than other insurers for some tests, HHS' Office of Inspector General found. The program shells out about $7 billion a year for clinical diagnostic laboratory tests. (Dickson, 12/11)
Medical Lab Trade Group Sues Over U.S. Reimbursement Cuts
The lawsuit came after CMS last month rolled out deep cuts to reimbursement rates for some lab tests under Medicare that could save the government as much as $3 billion over five years but could hurt laboratory companies’ margins. In its lawsuit, ACLA argued that while [the Protecting Access to Medicare Act] required all “applicable laboratories” report market information on private payors, CMS had arbitrarily exempted 99.3 percent of the laboratory market from the reporting requirement. (Raymond, 12/11)