The Centers for Medicare & Medicaid Services will no longer allow independent laboratories to directly bill Medicare for the technical component of physician pathology tests after Dec. 31, according to the 2007 physician fee schedule final rule. CMS maintains in the Nov. 1 rule that the hospital prospective payment amount adequately pays hospitals for the technical component, which involves preparing slides for interpretation and examining tissue removed during surgery.
The American Hospital Association believes that the costs are not included in the inpatient diagnosis-related groups and outpatient ambulatory patient categories and that eliminating the payment to independent labs would be especially burdensome for small and rural hospitals. In addition, hospitals with long-standing arrangements with labs to provide technical pathology services would have to establish costly new billing systems and procedures to pay labs directly.
The AHA supports the Physician Pathology Services Continuity Act (S. 3609), sponsored by Sens. Blanche Lincoln, D-AR, and Craig Thomas, R-WY, and its companion bill, H.R. 6188, sponsored by Reps. Kenny Hulshof, R-MO, John Tanner, D-TN, and Mike Ross, D-AR, which would require Medicare to continue paying laboratories for the technical component of physician pathology services furnished to hospital patients.
[ via AHA News Now ]