Joyce Gresko spoke at the Institute on Medicare and Medicaid Payment Issues conference sponsored by AHLA. The conference brought together knowledgeable private sector speakers with representatives from various government agencies to discuss legal issues related to reimbursement.
Joyce hosted the “Clinical Laboratories” session. Clinical laboratories are in the midst of dramatic changes to the way that their payment rates are established, what it takes to get coverage for tests, and whether and how laboratory tests are bundled into comprehensive payments. Recent developments affecting laboratories include:
- CMS’s implementation of new Clinical Laboratory Fee Schedule rates under the Protecting Access to Medicare Act (PAMA)
- Recent reimbursement changes for molecular pathology tests
- Changes to the local coverage determination process
- Fraud and abuse concerns raised by the recently passed Eliminating Kickbacks in Recovery Act
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