MAG among groups expressing concerns over CLFS

The Medical Association of Georgia (MAG) is one of more than 50 state and national physicians’ advocacy organizations that signed a letter that was sent to the Centers for Medicare and Medicaid Services (CMS) on April 27 to express “serious concerns that Medicaid beneficiaries in a number of states are on the verge of losing access to clinical testing services, including convenient and expedient in-office testing services” – keeping in mind that CMS recently implemented a new payment system for clinical laboratory testing services that are paid on the Clinical Laboratory Fee Schedule (CLFS).

The American Medical Association (AMA) is stressing that, “This new market-based system is resulting in cuts to reimbursement for clinical testing services, including those provided at the point of care by physician office-based labs. While cuts in this initial year of the new payment system are capped at 10 percent, cuts over the next two years will likely total more than 30 percent from 2017 payments. The AMA expects that the new payment system will continue to result in declining reimbursement for these services even past the initial few years unless changes are made. If reimbursement for these services continues to decline, the AMA is concerned that physician offices will no longer be able to offer these testing services at the point of care.”

AMA is “particularly concerned about the impact of Medicaid payment policies in light of the new CLFS payment system. As some Medicaid systems reimburse for testing services at a rate lower than the Medicare CLFS payment rates, there is an imminent threat that patients in these areas could lose access to physician office-based testing services sooner rather than later.”

Click for letter

Click for additional information