CMS changes to Lab billing

[Anonymous]

A Client of mine showed me some proposed changes to Physician Payments by CMS. Essentially the Doc would get a fixed sum for a diagnosis code that includes labs. Labs would not have separate billings. Just like inpatient hospital MS-DRG billing. If this is true, what effects do you think this will have to clinical labs such as LCA? Anyone heard any scuttlebutt regarding this type of payment change?

 

[Anonymous]

I believe this only applies to work coming from a hospital or ASC.

 

[Anonymous]

From what I understand (which admittedly not great), the problem is delayed payments since labs must be reimbursed after hospitals receive payments. And I think hospitals have some discretion in just how much of the reimbursement pie they want to pass on to the labs. That is how our docs described it. Is this at least a ball park understanding?

 

[Anonymous]

I heard that SpongeBob Square pants is opening a lab. He told me at Bikini Bottom this morning. He pays with Krabby Paddy's. Soooo good. LabCorp sucks cockles!!!

 

[Anonymous]

As I understand this it mean the doc will get a payment for a diagnosis code, let say it's $75 for a physical. Right now the lab is billed separate with it own margin for the doc or the lab, CBC, Cholesterol, PAP, et has its own reimbursement. going forward the Lab is bundled into the DRG. Now Lab is a true cost center to the doc not unlike hosptial labs are for inpatients. If this is true how does this effect the Quest and LCA of the world?

Private insurance does follow the CMS lead....