Compliance Today (March 2020)

According to the Centers for Medicare & Medicaid Services (CMS) MLN Connects, “For Clinical Diagnostic Laboratory Tests (CDLTs) that are not Advanced Diagnostic Laboratory Tests (ADLTs), private payor data reporting is delayed by one year. CDLT data that was supposed to be reported between January 1, 2020, and March 31, 2020, must now be reported between January 1, 2021, and March 31, 2021. Labs must report data from the original data collection period of January 1, 2019, through June 30, 2019. Data reporting for these tests will resume on a three-year cycle, beginning in 2024. (Section 105(a)(1) of the Further Consolidated Appropriations Act of 2020 (FCAA)).

“In addition, the statutory phase-in provisions are updated. For 2020, the rates for CDLTs that are not ADLTs or new CLDTs may not be reduced by more than 10% of the rates for 2019. There will be a 15% reduction cap for each of 2021, 2022, and 2023. (Section 105(a)(2) of FCAA). The reduction cap for CDLT rates:

• “2020: 10% based on the January 1, 2017 – May 30, 2017 reporting period

• “2011: 15% based on the January 1, 2017 – May 30, 2017 reporting period

• “2022: 15% based on the January 1, 2021 – March 31, 2021 reporting period

• “2023: 15% based on the January 1, 2021 – March 31, 2021 reporting period”

For more visit the PAMA Regulations webpage (https://go.cms.gov/2FBXriV).

Also, for more from January 9, 20920 MLN Connects: https://go.cms.gov/307M7Ew

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