Comments Due April 26 Regarding MSA Proposed Lab Payment Rate Updates

Posted on April 20, 2018

The MHA’s comments regarding the proposed policy from the Medical Services Administration (MSA) to update the Medicaid fee-for-service (FFS) payment rates for services paid based on the clinical laboratory fee schedule (CLFS) are available for hospitals to use as they prepare their own comments.

The proposed policy was created in response to the Protecting Access to Medicare Act (PAMA) of 2014, which required Medicare to adjust payment rates based on the weighted median of private payor rates.  The proposal would update Medicaid CLFS rates annually effective July 1, 2018, for affected providers. The proposed policy indicates that Medicaid currently pays 90 percent of the Medicare rate for these services.

In its comment letter, the MHA seeks clarification regarding:

  • Whether the proposed changes apply for hospital laboratory services that are billed separately on a facility claim or to only those billed on a professional claim;
  • The estimated financial impact of the updated Medicaid payment rates for hospital laboratory payments; and
  • The overall financial impact of the proposed policy.

The MHA encourages members to submit comments to the MSA by April 26. Members with questions should contact Vickie Kunz at the MHA.



Tags: MSA, proposed policy, CLFS

Posted in: Member News

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