At the beginning of August, CMS announced the membership of its new Congressionally required expert panel on laboratory issues, including payment and coverage (article here). The panel held its first meeting on site at CMS in a public hearing on August 26, 2015.
Note: CMS also convened the panel AFTER its preliminary price postings; that second panel meeting was October 19, 2015.
Added 10/2017: Unofficial uncorrected transcript of the August 26 meeting, here.
Note: CMS also convened the panel AFTER its preliminary price postings; that second panel meeting was October 19, 2015.
Added 10/2017: Unofficial uncorrected transcript of the August 26 meeting, here.
See the full day meeting agenda, PDF online at CMS, here.
The expert panel, like almost all discussants in the July 26 regular annual CLFS meeting, dissed the CMS plan to have 2 drug monitoring codes for rehab/pain centers.
The expert panel, like almost all discussants in the July 26 regular annual CLFS meeting, dissed the CMS plan to have 2 drug monitoring codes for rehab/pain centers.
Marc Hartstein announced the PAMA rulemaking (a new CLFS pricing system) should be out in mid September. Some had expected it as early as mid spring.
Some parties complained about the CMS MAC gapfill
process was far from optimal, but CMS ruled that MAC gapfill behavior
was not an agenda topic of discussion.
The panel voted no pricing change desired for Exact Sciences' Cologuard test (press release here, Genomeweb [subscr.] here.)
The panel voted no pricing change desired for Exact Sciences' Cologuard test (press release here, Genomeweb [subscr.] here.)
The 6 hour panel is up on the Medicare Youtube channel already, split into morning and afternoon sessions:
https://www.youtube.com/watch?v=kZV6CZ7FaKM
Coverage at the trade journal Gray Sheet (subscr.) is here.
Advisory Panel on Clinical Diagnostic Laboratory Tests
Agenda
Centers for Medicare & Medicaid ServicesAuditorium
Wednesday, August 26, 2015
This meeting provides a forum for interested parties to make presentations and submit written comments on new test codes for 2016. Please note that, for new test codes, we will be discussing only the codes addressed in our Clinical Laboratory Fee Schedule CY 2016 Updates, located on the web at [as PDF, here.]
Comments and recommendations on whether codes identified as gapfilled codes [e.g.: exome sequencing and other genomic procedures] from last year’s final determination is a separate and distinct process that will not be discussed at this meeting.
9:00 a.m. Welcoming Remarks Marc Hartstein Director, Center for Medicare, Hospital and Ambulatory Policy Group
9:15 a.m. Welcome and Panel Introductions Steve Phurrough, M.D Panel Chair, CMS Medical Officer
9:45 a.m. Welcome/Agenda/Crosswalk vs. Gapfill Valerie Miller Director, Center for Medicare, Division of Ambulatory Services
Session 1: New Code Crosswalks (not drugs)
10:00 a.m. Scheduled Public Presentations
Presenters (Proposed Order)
1. Aaron Bossler, M.D. Association for Molecular Pathology/College of American Pathologists 2. Shannon Curtis/Sylvia Trujillo American Medical Association
10:45 a.m. Open Public Presentations
11:00 a.m. Panel Deliberations/vote/recommendations
12:00 p.m. Lunch Break
1:00 p.m. Panel Deliberations/vote/recommendations Session
Drug Testing Structure
2:00 p.m. Scheduled Public Presentations
Presenters (Proposed Order) 1. Shannon Curtis/Sylvia Trujillo American Medical Association 2. Paul Sheives American Clinical Laboratory Association 3. Paul Radensky, M.D. McDermott+Consulting 4. . Heide Bajnrauh Coalition for Excellence in Medication Monitoring 5. Andrea Barthwell, M.D. Two Dreams Treatment Center 6. Michael Barnes Center for Lawful Access and Abuse Deterrence 7. Michael Arnold California Clinical Laboratory Association
2:45 p.m. Open Public Presentations
3:00 p.m. Break
3:15 p.m. Panel Deliberations/vote/recommendations
5:00 p.m. Meeting Adjourns
_____________________
To discuss how the changing healthcare system and Medicare policy affects your company, association, or investments, contact Dr Quinn through FaegreBD Consulting.
Coverage at the trade journal Gray Sheet (subscr.) is here.
As Online at CMS:
AGENDA
AGENDA
Advisory Panel on Clinical Diagnostic Laboratory Tests
Agenda
Centers for Medicare & Medicaid ServicesAuditorium
Wednesday, August 26, 2015
This meeting provides a forum for interested parties to make presentations and submit written comments on new test codes for 2016. Please note that, for new test codes, we will be discussing only the codes addressed in our Clinical Laboratory Fee Schedule CY 2016 Updates, located on the web at [as PDF, here.]
Comments and recommendations on whether codes identified as gapfilled codes [e.g.: exome sequencing and other genomic procedures] from last year’s final determination is a separate and distinct process that will not be discussed at this meeting.
9:00 a.m. Welcoming Remarks Marc Hartstein Director, Center for Medicare, Hospital and Ambulatory Policy Group
9:15 a.m. Welcome and Panel Introductions Steve Phurrough, M.D Panel Chair, CMS Medical Officer
9:45 a.m. Welcome/Agenda/Crosswalk vs. Gapfill Valerie Miller Director, Center for Medicare, Division of Ambulatory Services
Session 1: New Code Crosswalks (not drugs)
10:00 a.m. Scheduled Public Presentations
Presenters (Proposed Order)
1. Aaron Bossler, M.D. Association for Molecular Pathology/College of American Pathologists 2. Shannon Curtis/Sylvia Trujillo American Medical Association
10:45 a.m. Open Public Presentations
11:00 a.m. Panel Deliberations/vote/recommendations
12:00 p.m. Lunch Break
1:00 p.m. Panel Deliberations/vote/recommendations Session
Drug Testing Structure
2:00 p.m. Scheduled Public Presentations
Presenters (Proposed Order) 1. Shannon Curtis/Sylvia Trujillo American Medical Association 2. Paul Sheives American Clinical Laboratory Association 3. Paul Radensky, M.D. McDermott+Consulting 4. . Heide Bajnrauh Coalition for Excellence in Medication Monitoring 5. Andrea Barthwell, M.D. Two Dreams Treatment Center 6. Michael Barnes Center for Lawful Access and Abuse Deterrence 7. Michael Arnold California Clinical Laboratory Association
2:45 p.m. Open Public Presentations
3:00 p.m. Break
3:15 p.m. Panel Deliberations/vote/recommendations
5:00 p.m. Meeting Adjourns
_____________________
To discuss how the changing healthcare system and Medicare policy affects your company, association, or investments, contact Dr Quinn through FaegreBD Consulting.
