Understand how PAMA impacts the clinical laboratory industry and the repercussions of failing to comply with the law and its regulations.
Since 1984, Medicare has reimbursed for clinical diagnostic tests based upon an established fee schedule pursuant to the Social Security Act. The passage of the Protecting Access to Medicare Act of 2014, or ‘PAMA’, mandated extensive revisions to Medicare payment, coding and coverage requirements for such clinical laboratories and the testing they perform. Additionally, PAMA requires separate reporting requirements for designated clinical laboratories that were implemented over several years. This presentation will provide those who are responsible for billing, oversight and compliance for clinical diagnostic laboratories a platform on how PAMA impacts the clinical laboratory industry and the repercussions of failing to comply with the law and its regulations. The live webinar also identifies data collection and reporting requirements, data integrity rules and mandates data certification and confidentiality of the underlying information. This webinar is critical for clinical diagnostic laboratories to ensure these payment systems are met when seeking reimbursement.
Learning Objectives
- You will be able to define what clinical laboratories are subject to the Protecting Access to Medicare Act of 2014 (PAMA) reporting requirements.
- You will be able to describe how to comply with the PAMA reporting requirements.
- You will be able to discuss the elements of Data Integrity required of PAMA.
- You will be able to explain how to implement processes to ensure compliance with PAMA.
Agenda
Introduction
- History of Reporting Requirements for Clinical Laboratories
- Reasons for Expansion of Reporting Requirements
- Final Rule That Implements Pertinent Sections of the Protecting Access to Medicare Act of 2014 (PAMA)
Laboratory Reporting Requirements: Who and What Does It Impact
- What Is an Applicable Laboratories
- What Is Applicable Information
- What Is an Advanced Diagnostic Laboratory Test (ADLT)
How to Collect and Submit Data to Stay Compliant
- General Data Collection and Data Reporting Requirements
- Data Reporting Requirements for New ADLTS
- Private Payor Rate-Based Fee Schedule
Data Integrity
- Penalties for Non-Reporting
- Data Certification
- Confidentiality and Public Release of Limited Data
Conclusion
- Landmines and Other Traps
- What Is on the Horizon?
- Best Practices to Ensure Compliance
Speakers
Patrick D. Souter,
Gray Reed & McGraw LLP- Of Counsel, Gray Reed & McGraw LLP
- Representation of physicians, hospitals, and ancillary providers in operational, regulatory, and administrative matters
- Board certified in health care law by the Texas Board of Legal Specialization
- Adjunct professor of health care studies at Baylor University School of Law and frequent speaker to national and local health care organizations
- Recognized as a leading health care lawyer in Texas by Chambers & Partners USA (2020) and selected by his peers for inclusion in Woodward/White, Inc.'s The Best Lawyers in America in the field of health care law (2019 - 2021)
- Frequent author of books and articles for the American Health Law Association (AHLA) and American Bar Association (ABA) including co-authoring the AHLA’s Representing Physicians, 4th edition and the ABA’s Physician Law Evolving Trends and Hot Topics (2017- 2020 editions) and What is ... Medical Staff Peer Review?
- Frequent speaker on physician, hospital, and other provider issues
- Member of the American Bar Association, State Bar of Texas, American Health Law Association, American College of Healthcare Executives, and Health Care Compliance Association
- LL.M. degree in health law, Hofstra University; J.D. degree, Baylor University School of Law; M.B.A. degree in health services management, University of Dallas
- Can be contacted at 214-954-4135, psouter@grayreed.com or 1601 Elm Street, Suite 4600, Dallas, Texas 75201
Who Should Attend
This live webinar is designed for healthcare administrators, health information managers, medical records directors, compliance officers, risk officers, billing managers, coders, and other healthcare professionals.
