Medicare Lab Test Payment Stability: New Data Collection Rules
This act aims to ensure stable access to clinical diagnostic laboratory tests for Medicare beneficiaries. It changes how data on test prices are collected from private payers to make Medicare payment rates more accurate and reflective of market prices. This should lead to more predictable and fair coverage for citizens' laboratory test costs.
Key points
Changes in laboratory test price data collection: Medicare will use data from independent, national non-profit organizations with comprehensive private claims databases, aiming for more accurate rates.
New rules for widely available tests: For common, non-advanced laboratory tests, data will be collected from independent entities to better reflect market prices.
Payment reduction limits: The act modifies limits on payment reductions for laboratory tests, introducing a 5% reduction limit from 2029, which may affect laboratory financial stability and service availability.
Public explanation of payment rates: The Secretary must publicly provide explanations of test payment rates, including supporting data, increasing transparency and allowing citizens to assess calculation accuracy.
Introduced
Citizen Poll