Office-Based Lab Financial Reporting
Under the Protecting Access to Medicare Act, Medicare payments for tests on the Clinical Laboratory Fee Schedule (CLFS) will be based on rates paid by private payers. The new CLFS rate system, which will be determined by reports from applicable laboratories, is slated to take effect Jan. 1, 2018. The Centers for Medicare & Medicaid Services has pushed back to May 30, 2017, the deadline for physician office-based laboratories to meet new financial reporting requirements. The original deadline was March 31, 2017.
Under the rule, the penalty for failure to report or for each misrepresentation or omission in reporting will be up to $10,000 per day, adjusted for inflation.
To report applicable information, you must identify who will submit and certify your CLFS data. These two individuals must (1) register in the Enterprise Identity Management system, and (2) request a CLFS submitter or certifier role in the Fee-for-Service Data Collection System. The CLFS submitter must be certified in PECOS as a "user" or "authorized user" on the PECOS Medicare Enrollment forms (CLFS submitters must have their name appear within one of the following 855 application forms: A,B,C,I, or R). For more information, visit: