Understand how PAMA impacts the clinical laboratory industry and the repercussions of failing to comply with the law and its regulations.
Since 1984, Medicare has reimbursed for clinical diagnostic tests based upon an established fee schedule pursuant to the Social Security Act. The passage of the Protecting Access to Medicare Act of 2014, or 'PAMA', mandated extensive revisions to Medicare payment, coding and coverage requirements for such clinical laboratories and the testing they perform. Additionally, PAMA requires separate reporting requirements for designated clinical laboratories that were implemented over several years. This presentation will provide those who are responsible for billing, oversight and compliance for clinical diagnostic laboratories a platform on how PAMA impacts the clinical laboratory industry and the repercussions of failing to comply with the law and its regulations. The live webinar also identifies data collection and reporting requirements, data integrity rules and mandates data certification and confidentiality of the underlying information. This webinar is critical for clinical diagnostic laboratories to ensure these payment systems are met when seeking reimbursement.
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Agenda
Introduction
- History of Reporting Requirements for Clinical Laboratories
- Reasons for Expansion of Reporting Requirements
- Final Rule That Implements Pertinent Sections of the Protecting Access to Medicare Act of 2014 (PAMA)
Laboratory Reporting Requirements: Who and What Does It Impact
- What Is an Applicable Laboratories
- What Is Applicable Information
- What Is an Advanced Diagnostic Laboratory Test (ADLT)
How to Collect and Submit Data to Stay Compliant
- General Data Collection and Data Reporting Requirements
- Data Reporting Requirements for New ADLTS
- Private Payor Rate-Based Fee Schedule
Data Integrity
- Penalties for Non-Reporting
- Data Certification
- Confidentiality and Public Release of Limited Data
Conclusion
- Landmines and Other Traps
- What Is on the Horizon?
- Best Practices to Ensure Compliance
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Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Credits
OnDemand Course
This course was last revised on September 12, 2024.
Call 1-866-352-9540 for further credit information.
- AHIMA 1.0 including Clinical Foundations 1
- This program has been approved for 1.0 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
This program does NOT qualify, nor meet the National Standard for NASBA accreditation.
MP3 Download
This program does NOT qualify, nor meet the National Standard for NASBA accreditation.
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Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Faculty
Patrick D. Souter
Gray Reed & McGraw LLP
- Of Counsel, Gray Reed & McGraw LLP
- Representation of physicians, hospitals and ancillary providers in operational, regulatory and administrative matters
- Board Certified in Healthcare Law by the Texas Board of Legal Specialization
- Adjunct Professor of Healthcare Studies at Baylor University School of Law and the Baylor University Hankamer School of Business’ Robbins Institute for Health Policy and Leadership
- Frequent speaker to national and local healthcare organizations on physician, hospital and other provider issues
- Recognized as a leading healthcare lawyer in Texas by Chambers & Partners USA (2020 - 2023) and selected by his peers for inclusion in Woodward/White, Inc.’s The Best Lawyers in America in the field of Health Care Law (2019 - 2023)
- Frequent author of books and articles on various topics
- LLM degree in Health Law from Hofstra University; JD degree from Baylor University School of Law, MBA degree, Health Services Management from the University of Dallas, BBA degree, in Finance from Baylor University Hankamer School of Business
- Can be contacted at [email protected] or (214) 954-4135
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