A coalition representing more than 120,000 medical and laboratory professionals and institutions that perform the vast majority of clinical molecular pathology testing in the United States have released a joint statement regarding new Medicare prices for those tests.
The groups include American Association for Clinical Chemistry (AACC), American Clinical Laboratory Association (ACLA), American College of Medical Genetics and Genomics (ACMG), American Society for Clinical Pathology (ASCP), American Society for Histocompatibility and Immunogenetics (ASHI), Association for Molecular Pathology (AMP), California Clinical Laboratory Association (CCLA), College of American Pathologists (CAP), and Society for Inherited Metabolic Disorders (SIMD).
The coalition’s concerns include cuts in reimbursement for molecular pathology tests, denials of claims without publication of sufficient information on the basis for those decisions, and incorrect determinations that certain tests are investigational.
Their recommendations include removing coverage and payment restrictions, providing greater transparency about the evidence for coverage decisions and basis for payment decisions, extending the period for reconsideration of denials, and convening stakeholder meetings with CMS.
Click here to read the statement.