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Labs Sue CMS Over Planned Cut

Posted on by Drea

December 12, 2017

Modern Healthcare – Virgil Dickson

Clinical labs are suing the CMS over a planned multibillion-dollar cut to their reimbursement.

They expect to lose $670 million next year as part of a CMS effort to pay the same rate for tests as private payers.

Medicare’s fee schedule for lab tests has been largely unchanged since it was established in 1984. Each lab determines its own rates based on market prices. Medicare has historically paid 18% to 30% more than other insurers for some tests, HHS’ Office of Inspector General found. The program shells out about $7 billion a year for clinical diagnostic laboratory tests.

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