On December 19th, 2019 the Laboratory Access for Beneficiaries (LAB) Act was passed by Congress. This major success delays PAMA reporting by one year allowing labs more time to gather and report accurate data. Reporting originally scheduled between January 1 and March 31, 2020 is now delayed until January 1 to March 31, 2021.
What does this mean?
Clinical Diagnostic Laboratory Tests (CDLTs) that are not Advanced Diagnostic Laboratory Tests (ADLTs) are delayed for reporting by one year; however, the data period of January 1 to June 30, 2019 remains the same. New payment rates derived from this data are expected to take effect in 2022, instead of 2021.
The scheduled 10% reduction to the CMS Clinical Lab Fee Schedule for 2020 has still gone into effect and is based on the weighted median of previously reported data.
The LAB Act requires a study to be conducted in 2020 on how to improve the data-collection process and rate-setting. The hope is that the study will find a more equitable solution for drawing payment data from across the industry instead of just a small sector. This will better reflect Congress’ original intent of creating a market-based fee schedule for clinical laboratory services.