On Friday, December 10, 2021, President Biden signed into law the “Protecting Medicare and American Farmers from Sequester Cuts Act.” In accordance with this Act, reporting of private payor payment data due to PAMA Regulations has been delayed from 1/1/2022 to 1/1/2023. The data collection period for the reporting will stay the same, which is claims with dates of service 1/1/2019-6/30/2019. In addition to the delayed reporting requirement, the reduction cap on all testing priced on the Clinical Laboratory Fee Schedule (CLFS) has been adjusted down to 0%. This is great news for clinical laboratories, who have spent endless resources in the fight to combat COVID 19 over the past 2 years.
The CLFS will be subject to rate reductions of up to 15% for any CPT® that the CMS deems to be overpriced based off data previously submitted, in 2023.