CMS

OIG will evaluate data to assess whether PAMA pricing results in market-based rates

The Garage's web-based platform is used exclusively by groups that employ value-based payment models

Smaller labs, hospital outreach labs, and labs servicing high numbers of elderly are thought to face the highest risks.

The increase was largely due to a 13 percent rise in clinical lab revenues, driven by sales of molecular diagnostic tests, particularly in women's health.

Piper Jaffray analyst William Quirk said the pricing, which was much higher than expected, will help push CareDx toward profitability.

The biggest losers following the release of the preliminary PAMA rates may be Quest and LabCorp, analysts said today. 

The government payor proposed rates that would reduce payment by $670 million, though CMS previously estimated a $390 million cut in 2018.

Since last year the AMA has issued 23 PLA codes for firms that want to better track use of their tests, but the effect of the codes on improving reimbursement remains to be seen.

The final LCD covers AlloSure in renal allograft recipients who have a probability of active renal allograft rejection.

On a conference call, the firm's CEO said that it and other industry players are pushing to postpone implementation of PAMA to no earlier than July 1, 2018. 

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