Pay-Formula Glitch Could Lead to Drastic Cuts For Certain Diagnostics

Makers of advanced diagnostics say they were surprised to discover recently that CMS plans to cut Medicare reimbursement for their tests by 30 percent to 70 percent because of a glitch in the formula for setting interim prices while CMS takes an additional year to implement the new lab fee schedule. Although they’re meant to be temporary, the interim rates could permanently drive Medicare rates lower than Congress intended, a lobbyist for diagnostics makers says. Congress passed the Protecting Access...