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Congress halts laboratory data reporting, addresses CLFS rate deficiencies

Washington Connection

Medicare Payment Policies

January 6, 2020: Every three years, clinical laboratories, including some physician office laboratories (POLs), are required to report private payer rates for diagnostic testing to CMS to calculate the Clinical Laboratory Fee Schedule (CLFS). As part of the appropriation package signed into law in late December, Congress delayed the data reporting period that was set to start on Jan. 1, 2020 by one year. Congress is also requiring that an independent entity provide recommendations on a less burdensome data collection method and more accurate formula for calculating the CLFS. MGMA has repeatedly warned CMS about the negative effects of cutting laboratory reimbursement and opposes burdensome reporting requirements for POLs. For more information, please visit MGMA’s CLFS landing page.
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