CMS wird im September 2016!!! bereits vorläufig über Epi proclon Erstattung entscheiden, sh. Artikel
Laboratory Public Meetings Public Meeting for the Laboratory Payment for New Clinical Test Codes for 2017 July 18, 2016 Centers for Medicare & Medicaid Services Auditorium 7500 Security Blvd Baltimore MD 21244-1850 410-786-5723
The Public Meeting for new and reconsidered Clinical Laboratory Fee Schedule services will take place on Monday, July 18, 2016. We will accept public comments from that meeting for approximately 1 week. Then, we will determine the basis of payment (either crosswalk or gapfill) and we will post the preliminary determinations on our web site in September, 2016. We will accept additional comments from these preliminary determinations through October, 2016. The basis of payment and the amount of payment will become final at the same time that we issue the annual CMS instruction for CY 2017 (approximately November). Then, the public has 60 days from the date we issue our annual instruction to request reconsideration of either the basis of payment or the amount of payment for these new test codes. And, the public may comment on any reconsideration requests at the next Annual Public Meeting. In addition, for any new test code that will be gapfilled, we ask our Medicare contractors to develop carrier-specific gapfilled amounts by April 1 of the following year. These amounts will then be finalized on September 30 of that year. Unlike a crosswalk test, the payment amount for a gapfill test is not established when we determine the basis for payment because it takes approximately 9 months for our contractors to establish carrier-specific amounts. After these prices are developed by the Medicare contractors, we will post them on our web site and accept comments for 60 days after April 1 (not reconsideration requests, just comments). Later in the year, when the gapfilled payment amounts are posted on the web site as final, we will accept reconsideration requests on the gapfilled payment amounts for 30 days. Once the reconsideration process is completed for a cycle, the determination is final and would not be subject to further reconsideration.
In addition, the Advisory Panel on Clinical Diagnostic Laboratory Tests will meet in conjunction with the Public Meeting. The meeting announcement for the Advisory Panel meeting was published in a separate Federal Register Notice. As discussed in more detail in the notice, the Panel will specifically gather information regarding new and reconsidered test codes, and preliminarily make recommendations. Additional panel meeting dates in the future will be addressed at a later time. |