On October 27, 2014, CMS published a notice announcing that it is establishing an Advisory Panel on Clinical Diagnostic Laboratory Tests, as authorized by the Protecting Access to Medicare Act of 2014 (PAMA). The Panel will provide recommendations to CMS on the following issues:

  • Calculation of weighted median for laboratory services using private payor rates.
  • Phase-in of reductions from private payor rate implementation.
  • Application of market rates.
  • Evaluation and designation of tests as advanced diagnostic laboratory tests.
  • Whether to use crosswalking or gapfilling to determine payment for a specific new test.
  • The factors used in determining coverage or payment processes for new clinical diagnostic laboratory tests.

CMS is requesting nominations for individuals to serve on the panel, which will consist of up to 15 individuals with expertise in issues related to clinical diagnostic laboratory tests, which may include representatives of clinical laboratories, molecular pathologists, clinical laboratory researchers, and experts in clinical laboratory science or the economics of clinical laboratory services. The deadline for submitting nominations is on November 26, 2014.