Deep Medicare Fee Cuts Are Coming to your Clinical Laboratory in 157 Days: What You Must Do Now, Why Congress Might Intervene, and Action Steps to Protect Your Lab’s Financial Integrity
Webinar was held
Thursday, July 20, 2017
On January 1, 2018, the Medicare program starts to pay less—much less—to your medical laboratory for your highest-volume, most-automated lab tests than what you are paid today. Experts say these price cuts to the Medicare Part B Clinical Laboratory Fee Schedule (CLFS) will be the single most disruptive financial event to our industry in three decades.
Only 157 days remain before your lab will begin to see the financial impact from these deep Medicare fee cuts. To help you and your lab management team respond in a timely way to this threat, Dark Daily presents an all-new webinar entitled, “Deep Medicare Fee Cuts Are Coming to your Clinical Laboratory in 157 Days: What You Must Do Now, Why Congress Might Intervene, and Action Steps to Protect Your Lab’s Financial Integrity.” This webinar, recorded Thursday, July 20 at 1PM EDT, will provide you with an insider’s perspective on the essential market intelligence and knowledge you need to respond to the loss of important revenue that your lab will experience as of January 1.
No less than a “must attend” session for all hospital and health system laboratory administrators who have significant clinical laboratory outreach programs, the webinar is also essential knowledge for executives at independent lab companies where Medicare payments are a major source of revenue and thus the need to maintain the financial solvency of their lab organizations is paramount.
The webinar opens with an incisive analysis of what officials at the Centers for Medicare and Medicaid Services (CMS) are doing to implement the PAMA private payer lab test price reporting rule, with lower prices scheduled to take effect on January. 1. Your expert presenter on this topic, Lâle White, Executive Chairman and CEO, XIFIN, Inc., San Diego, CA, has a unique understanding of the flaws and problems in the PAMA final rule for market price reporting.
White and her colleagues at XIFIN have access to a remarkable pool of real-world clinical laboratory price data. XIFIN provides clinical lab test billing and collection services to hundreds of medical labs across the nation. Not only does XIFIN handle as many as 300 million lab test claims each year, it is electronically interfaced with every health insurance plan in this country. Simply said, White has essentially the same data that these lab clients reported to CMS.
She will show you how her analysis was conducted using the real information from hundreds of millions of medical lab test claims that were reimbursed by thousands of private payers. You are in for a big surprise!
XIFIN’s conclusions—based on its real-world data and how the CMS final rule is written to direct the way federal officials calculate and set the 2018 Part B clinical laboratory test prices—demonstrate why the fee cuts will be deep and painful for the lab industry’s highest-volume tests.
You’ll learn why critics of the CMS PAMA marketing price reporting rule were upset that CMS is using a “weighted median” and not a “weighted average” of the private payer lab test price data it received from those labs required to report. This is essential insight that will help you craft the right strategies to help your laboratory absorb the decline in Medicare revenue your lab will experience in 2018.
White will also discuss the different risks your lab faces when CMS audits the data your lab submitted in compliance with the PAMA final reporting rule. She has sound advice on how labs should document that data and be prepared to deal with the auditors.
Next to speak is Julie Scott Allen, Senior Vice President, District Policy Group, representing the National Independent Laboratory Association (NILA) in Washington, DC. In this role, Allen works with officials at CMS, within the Department of Health and Human Services, and members of Congress on issues relevant to the clinical laboratory members of NILA, and regularly participates as part of the Clinical Laboratory Coalition on these matters.
As part of her presentation, Allen will give you an up-to-the minute perspective on efforts by the clinical laboratory industry to educate officials within Congress, HHS, and CMS about the consequences of allowing the PAMA final rule price cuts to become effective on January 1.
You’ll learn about the progress she and other clinical lab representatives are making, regarding getting certain Senators and Representatives to understand why, if the Medicare fee cuts happen as planned, the hospital lab outreach programs and community lab companies in their states and districts will probably end up going out of business, filing bankruptcy, or selling to a national lab company.
For example, last December, Allen and her collaborators succeeded in getting eighty-eight members of Congress to sign a bi-partisan letter to the HHS Secretary urging HHS to revisit the CMS final rule, delay its implementation, and make needed reforms.
Allen will also help you understand what courses of action remain for the clinical laboratory industry to delay implementation of the PAMA final rule and reform it.
Here’s just some of what you’ll learn during this indispensable 90-minute session:
- Understand precisely what the language of the CMS PAMA final rule allows the federal agency to do to cut Part B clinical lab test fees
- Identify useful steps your lab can take now to offset the negative revenue impact from the Part B lab fee cuts that happen on January 1
- Assess how XIFIN’s private payer weighed average prices for the top 20 lab tests compare to your lab’s current Medicare payments for those tests
- Prepare for the specific risks your lab faces if Medicare auditors show up to review the private payer price data that you submitted
- Grasp what elements of the PAMA final rule are harmful to the clinical lab industry and how your lab should respond to these threats
- Discover the specific elements of the CMS final rule that critics say may violate the PAMA statute as passed by Congress
- Begin the action steps your lab team can take now to financially prepare your lab to absorb the coming loss in Medicare revenue
- Review how the Clinical Laboratory Coalition is educating members of Congress about the harmful consequences of the CMS final rule
- Learn the latest developments in meetings between CMS officials and clinical lab leaders to seek delay and reforms to the final reporting rule
This timely webinar will help you use the 157 days remaining before the Medicare Part B clinical lab fee cuts take effect to best advantage. Nothing less than the financial health of your hospital or independent lab is at stake—which is why it’s particularly important that you have each and every one of your lab’s team members together to participate.
You can protect your lab’s finances, but only if you have the crucial knowledge and information about the PAMA final rule to craft the right strategies and action plan.
Lâle White, Executive Chairman and CEO, XIFIN, Inc., San Diego, CA.
Lâle White is a nationally recognized expert in the field of medical financial management and regulatory compliance, with over 25 years of experience in information systems development and medical billing. White lectures extensively on these topics and has consulted for major laboratories and laboratory associations throughout the United States.
White worked with the Health Care Finance Administration and the United States Office of the Inspector General to develop the first OIG Model Compliance Program. She was previously Vice President-Finance at Laboratory Corporation of America (NYSE: LH), one of the largest clinical reference laboratories in the United States, and its predecessor National Health Laboratories (NYSE: NHLI), where she led the software development of several accounts receivable, inventory, cost accounting, and financial management systems for the laboratory industry.
White has a Bachelor of Arts degree in finance and a Master of Business Administration degree from Florida International University. She is a member of the Board of Directors of Combimatrix, a molecular diagnostics company specializing in DNA-based testing services for pre- and postnatal developmental disorders.
Julie Scott Allen, Senior Vice President, District Policy Group, Representing the National Independent Laboratory Association, Washington, D.C.
Julie Scott Allen has over two decades of experience as a government relations professional, advocating at the federal and state level to address Medicare and Medicaid payment and coverage and health care reform. She represents the interests of independent clinical laboratories through the National Independent Laboratory Association (NILA), serving as their Washington Representative and advocating before Congress and such agencies as the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA).