The Centers for Medicare & Medicaid Services (CMS) has just announced that it is extending until May 30, 2017 the deadline for certain clinical laboratories to report to CMS private payor reimbursement information. As required by the Protecting Access to Medicare Act of 2014 (PAMA) and its implementing regulations, this data will be used to set Medicare clinical lab fee schedule (CLFS) rates beginning in 2018.
CMS previously required applicable private payer data to be submitted by March 31, 2017. In a March 30 announcement, CMS stated that it is granting a 60-day extension in recognition that clinical labs need more time to review collected data, address any identified issues, and compile the data using CMS’s required reporting format.
During this extension period, CMS will exercise its “enforcement discretion” with respect to the potential assessment of civil monetary penalties for failure to report applicable information. According to CMS, 60 days is the longest delay that will still enable the agency to calculate CLFS payment rates based on the reported private payer data for calendar year 2018. Additional information regarding the PAMA CLFS data reporting requirements is available on the CMS web site.