Press Release: Hospitals May Face Federal Penalties of $10,000 Per Day If They Fail to Report PAMA Private Payer Clinical Laboratory Test Price Data to CMS in Early 2020

PRESS RELEASE

THE DARK REPORT
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FOR IMMEDIATE RELEASE

Media Contact: Chris Garcia
chris@darkreport.com

AUSTIN, Texas (April 1, 2019) — Recent surveys indicate that a majority of the nation’s hospital and health system CEOs and CFOs are unaware of the requirement that they report their private payer clinical laboratory test price data to the federal Centers for Medicare and Medicaid Services (CMS) starting Jan. 1, 2020. Hospitals that fail to report this data may be assessed penalties of up to $10,000 per day.

To help hospital CEOs, CFOs, and their medical laboratory administrators fulfill this federal law, the 24th Annual Executive War College on Lab and Pathology Management will present a full-day workshop on how to comply with the PAMA reporting requirement. It will happen in New Orleans on Thursday, May 2.

This data-reporting requirement is part of the Protecting Access to Medicare Act of 2014 (PAMA). Hospitals with a clinical laboratory that meets the definition of “applicable laboratories” are required to report to CMS the prices their labs were paid for every test by every private health plan, including volume. The federal penalty of $10,000 per day can be assessed for failure to report, or for submitting incomplete and/or inaccurate private payer lab price data.

“Last December, a survey of hospital and health network C-level administrators conducted by Modern Healthcare and Quest Diagnostics revealed that nearly 80% of survey respondents were unaware that their institutions met the definition of ‘applicable laboratory’ and were thus legally required to report the clinical laboratory test prices they were paid by private health insurers,” explained Robert L. Michel, Editor-In-Chief of The Dark Report.

“The fact that a majority of hospital CEOs and CFOs remain unaware of the PAMA law’s price reporting requirement means that their hospitals and health networks are exposed to the substantial—but unnecessary risk—of hefty federal penalties,” continued Michel. “To help these CEOs and CFOs is our full-day workshop, ‘What Every Hospital and Health Network Lab Must Know to Comply with PAMA Private Payer Price Reporting’.”

Speakers include clinical lab CFOs from South Bend Medical Foundation and Atrium Health, with experience in reporting PAMA price data, plus representatives from the CMS and experts from XIFIN, Alston and Bird, DV & Associates, Change Healthcare, and McDonald Hopkins. Attendees will gain practical experience in the most effective ways to collect the PAMA private payer lab test price data, analyze it, and report it. They will learn pitfalls to avoid, and how to identify and handle the inaccurate data health insurers often include on remittances for clinical laboratory test claims.

Full details on speakers and sessions, and how to register for the Executive War College and this PAMA Price Reporting Workshop are at https://www.executivewarcollege.com/register. Or, for additional information, contact  Chris Garcia at 512-264-7103.

About THE DARK REPORT

Established in 1995, The Dark Report is the leading source of exclusive business intelligence for laboratory CEOs, COOs, CFOs, Pathologists and Senior industry executives. It is widely-read by leaders in laboratory medicine and diagnostics. The Dark Report produces the famous Executive War College on Laboratory and Pathology Management every spring.

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