CMS holds two meetings each summer for pricing of new lab tests. One is a public comment meeting (June 25, 2024), the other is an expert advisory panel which is livestreamed (July 25-26, 2024).
Find the expert panel announcement here:
Find the public meeting announcement here:
Track updates on the CMS CLFS annual meeting page:
UPDATE 4/18: CMS has posted a code list (74 codes), a template for comments (the same 74 codes but with more columns), and an updated Powerpoint template for public presentations. All the new GSP codes from last year (such as CGP liquid biopsy) are under Reconsideration. Otherwise there are only a handful of new CPT 80,000 series codes - several variants of Alzheimer testing (tau, beta-amyloid).
CMS knows the code list is preliminary. We've seen that some 60 PLA codes, plus some new GSP codes, will be at the May 2024 AMA CPT meeting, and those will probably be rolled in to the final June agenda.
I think the PowerPoint template is updated to bring more focus on cost information. There's a slide to provide "test background" and "purpose and methodlogy." There's a slide asking you to present, "resources for test," and "costs" and "charges." On the last slide, they ask you to petition for either a crosswalk or gapfill price, and explain why.
For updates specific to the expert panel meeting, here:
For several years, the meetings have been virtual-only. This year they will be "hybrid" (both in the CMS auditorium in Baltimore, and live-streamed).
PUBLIC COMMENTS
Public comments must be submitted by May 30, 2024 5 pm ET. Use a PPT template for your opening slides which captures basic info in a fixed format.
The Code Agenda - Wait for it....
The code list (likely well over 100 codes this year) will be released 30 days before the meeting, e.g. May 25. Assuming you know whether you have a code in the ring or not, you don't have to wait for the May posting by CMS to start working on your slides. CMS will include codes that "pass" the CPT around May 10, but it takes a while for AMA to get those codes over to CMS to post.
International:
Although I don't see any explicit remarks, in some past years, if you have a non US passport, the advance requirements to attend were very elaborate and no exceptions. If this pertains to you, I suggest you touch base with CMS ASAP.
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AI CORNER
Having read the PDF about the experts advisory meeting, retell the story in the style of an old fairy tale.
ChatGPT
Once upon a time, in a realm governed by the wise and just, there existed a venerable gathering known as the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests. This illustrious panel, summoned by the Secretary of the Department of Health and Human Services, was a convocation of the most learned and sagacious minds from across the kingdom, each a master in their own right of the arcane arts of laboratory science and health economics.
In the heart of a grand hall, under the luminous glow of chandeliers that danced with light, the panel convened twice each circling of the sun. They were charged with a task of great import: to deliberate upon the mystical codes of new and reconsidered clinical diagnostic laboratory tests, deciding how gold—the coin of the realm—should be apportioned for their use.
The Panel, composed of molecular pathologists, seasoned researchers, and sages with deep knowledge of laboratory workings, employed ancient methods known as "crosswalking" and "gap filling" to cast their decisions. Crosswalking was a method where the value of a new test was measured against the worth of tests of old, linking them like the stones of a castle wall. Gap filling, on the other hand, was akin to charting unknown territories, setting values in places where no prior paths existed.
Each meeting was a spectacle of debate and discussion, with the panelists' words weaving through the air like spells, casting the future of medicine. They were watched by many, from near and far, through magical mirrors and devices that could capture their likeness and voice, spreading their deliberations across the kingdom in the blink of an eye.
The Panel’s recommendations were like golden keys that unlocked the treasury of Medicare, ensuring that the alchemists and healers across the land could continue their noble work, armed with the best of tools and knowledge. Their decisions were recorded in great ledgers and announced in the town squares and through messengers on swift horses, so that all could know of the wise determinations made within the grand hall.
Thus, the realm thrived, with the Panel’s wisdom guiding the health of its people. And so the story of the Medicare Advisory Panel on Clinical Diagnostic Laboratory Tests was woven into the fabric of the kingdom's history, a tale of wisdom and stewardship, told and retold wherever scholars gathered under the stars.
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Write a short, snappy, exciting summary of this CMS policy meeting announcement. Highlight some of the informational content like deadlienes, what kind of info to submit if you comment, etc.
Chat GPT4
Join us on June 25, 2024, for a pivotal public meeting hosted by the Centers for Medicare & Medicaid Services (CMS), where we will delve into the future of diagnostic healthcare through discussions on the Clinical Laboratory Fee Schedule (CLFS) for the upcoming year. This is your chance to contribute to shaping Medicare payment structures for new and reconsidered diagnostic laboratory test codes.
At this meeting, we will gather crucial feedback and recommendations on establishing payment amounts for innovative and substantially revised test codes. Whether you're a healthcare provider, patient advocate, industry professional, or a stakeholder in the medical laboratory community, your insights will help ensure equitable and effective payment schemes.
Important Deadlines:
Presentation and Comment Submission: If you wish to present or have your comments considered during the meeting, ensure your presentations and written comments are submitted electronically to the dedicated CMS email (CLFS_Annual_Public_Meeting@cms.hhs.gov) by May 30, 2024, at 5:00 p.m. EDT.
Special Accommodations Request: If you need special accommodations due to a disability, requests must be submitted by the same deadline of May 30, 2024.
What to Include in Your Comments:
Data-Based Recommendations: We seek detailed recommendations based on data that support your views on the appropriate basis for establishing payment amounts.
Details on New or Revised Tests: Include comprehensive information on the purpose, methodology, costs, and charges related to the new or reconsidered tests. This will aid in a transparent evaluation process.
Virtual and In-Person Participation:
The meeting will be accessible both virtually and in person at the CMS Central Building in Baltimore, Maryland, allowing participants from across the nation to join and contribute. If attending in person, registration is required, and we recommend arriving early to complete the security process.
Post-Meeting Actions:
Proposed Determinations Publication: CMS will publish proposed determinations by early September 2024. These will outline preliminary decisions on the payment amounts for each test code discussed during the meeting.
Final Comments on Proposed Determinations: Stakeholders will have until early October 2024 to submit written comments on these proposed determinations.
This meeting not only offers a platform to influence current policies but also to engage with key decision-makers and peers in the healthcare sector. Your participation ensures that the voice of the community is heard loud and clear in the decision-making process. Join us to help define the standards that will govern clinical diagnostic testing payments in 2025! [end/chat gpt]
