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Medicare Dx Payment System Will Be Market-Based, More Transparent Under New Law

A new law makes vast changes to how clinical laboratory tests will be reimbursed by Medicare over the long term. Although the changes ultimately may lead to payment reductions, both test kits makers and laboratories applaud the new provisions. Reimbursement will better reflect the value that lab tests bring to the health care system, they say.

Major reforms to the Medicare system for diagnostic tests signed by the president April 1 are expected to reduce overall payments for tests in the coming years, but both test kit manufacturers and clinical laboratories are optimistic about the new law.

Their reasoning: the new provisions include protections from overly drastic cuts, while greatly expanding transparency and public input into a historically opaque reimbursement process. Fundamentally, industry stakeholders say, the law...

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