Coalition for 21st Century Medicine Commends CMS for Issuing 2018 Final Private Payor Rate-Based Payment Amounts for Clinical Diagnostic Laboratory Tests as Part of PAMA Implementation

Washington, D.C. – On November 17, the Centers for Medicare & Medicaid Services (CMS) released the first Clinical Laboratory Fee Schedule (CLFS) reflecting private payor rate-based payment amounts as required by the market-based payment reforms enacted in Section 216 of the Protecting Access to Medicare Act of 2014 (PAMA). The Coalition for 21st Century Medicine (C21) strongly supported the enactment of these PAMA requirements to establish transparent, predictable, and market-based pricing for clinical diagnostic laboratory tests.

“C21 commends CMS for finalizing the private payor rate-based payment amounts following a public comment period,” said Hannah Murphy, Executive Director of C21. “We support the PAMA market-based rates going in effective on January 1, 2018 as required under the statute and implementing regulations.”

C21 also urges CMS to finalize a streamlined process for designating advanced diagnostic laboratory tests (ADLTs) which will serve as a catalyst for innovative tests that benefit patients by personalizing medical treatment decisions. Laboratories need additional guidance from CMS in order to be able to apply for ADLT status and receive designation prior to the effective date of January 1, 2018.

About the Coalition for 21st Century Medicine

The Coalition for 21st Century Medicine’s mission is to improve the quality of healthcare by encouraging research, development, and commercialization of innovative diagnostic technologies that will personalize patient care, improve patient outcomes, and substantially reduce healthcare costs. The group’s members include Aspira Labs, Bioarray Genetics, Biocept, Biodesix, Biotheranostics, CardioDx, CareDx, Castle Biosciences, Counsyl, Crescendo Bioscience, Foundation Medicine, GE, Genetic Alliance, Genomic Health, Guardant Health, Illumina, Kleiner Perkins Caufield & Byers, MDxHealth, Myriad Genetic Laboratories, Prometheus, Sera Prognostics, Vermillion, and Veracyte.