PAMA is here, and most hospital leaders are unaware of its impact

The Protecting Access to Medicare Act, or PAMA, has enacted dramatic changes to the Medicare Clinical Laboratory Fee Schedule (CLFS), and inflicted significant regulatory and reimbursement burdens on labs.

Signed into law on April 1st, 2014, PAMA has resulted in a significant reduction in payment for most lab tests. The new fee schedule includes a decrease in reimbursement for approximately 75% of lab tests that can be billed to CMS. CMS estimated the cuts to have an overall impact to the industry of nearly $670 million in the first year, or a nearly 10% decrease from the previous fee schedule. Similar cuts will follow over the next two years, and additional cuts are possible beyond 2020. These changes have the potential to create challenges for hospitals that are already dealing with rising costs and declining reimbursement in many other service lines.

Quest Diagnostics and Modern Healthcare Custom Media surveyed providers to assess their awareness of PAMA and gauge how healthcare organizations are responding to the law. Unfortunately, we found that most organizations are unaware of the law and unprepared to mitigate its impact. Download our executive brief to explore the results of the study and learn how your organization can ensure it is prepared for the law's long-term effects.