MHA Monday Report April 10, 2017

Posted on April 10, 2017

Enforcement of Reporting Requirements Delayed under Clinical Laboratory Fee Schedule

Due to concerns expressed by affected healthcare organizations, the Centers for Medicare & Medicaid Services (CMS) announced that the agency will exercise enforcement discretion until May 30 for the new data reporting requirements for clinical diagnostic laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS).

The CMS indicated that industry feedback has suggested many reporting entities were unable to submit a complete set of applicable information to the CMS by the March 31 deadline. These entities need additional time to review collected data, address any issues identified, and compile the data into the required reporting format.

Based on a final rule released in 2016, certain laboratories that have more than $12,500 in Medicare revenue from laboratory services on the CLFS and receive more than half of their Medicare revenue from laboratory and physician services during a data collection period are required to report private payer rate and volume data to the CMS. For hospitals, the requirement applies primarily to outreach laboratories that have their own national provider identifier. Additional information regarding the data reporting requirements is available on the CMS website. Members with questions should contact Vickie Kunz at the MHA.


  • MHA Monday Report April 10, 2017

Tags: Pyxis, Medicare, MAPS, Medicaid, pharmacy, Healthy Michigan Plan, Health PAC, Healthcare Leadership Award, Appriss, goal, Human Resources Conferance, WPS local coverage determination, sleep labs, Joint Commission, laboratory fee schedule, RCA2, MBI, HICN, Board meeting

Posted in: Monday Report

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