ARTICLE SUMMARY:
A change to how CMS collects commercial insurer rates paid to labs might better reflect market rates, but it is also likely to trigger more Medicare overspending on diagnostics, the Medicare Advisory Commission said. The lab industry criticized MedPAC’s June report, arguing it ignored the value of innovative tests.
An influential report to Congress this week, on the one hand, validates a long-argued point by commercial labs and test developers that CMS is paying less than market rates for tests because it is relying on a methodology that underrepresents the sector. On the other hand, the report from the Medicare Payment Advisory Commission (MedPAC) advises against CMS implementing a fix to the issue, arguing the Medicare agency has to focus on avoiding overspending.
