Friday, January 10, 2020

PL 116-94: DELAY OF PAMA (S.105)

Further Consolidated Appropriations Act of 2020 (FCAA).  See PL 116-94 (HR 1865) online herehere.  See: Division N, Title 1, Subtitle A, Section 105.

    (a) Amendments Relating to Reporting Requirements With Respect to 
Clinical Diagnostic Laboratory Tests.--
        (1) Revised reporting period for reporting of private sector 
    payment rates for establishment of medicare payment rates.--Section 
    1834A(a) of the Social Security Act (42 U.S.C. 1395m-1(a)) is 
            (A) in paragraph (1)--
                (i) by striking ``Beginning January 1, 2016'' and 
            inserting the following:
            ``(A) General reporting requirements.--Subject to 
        subparagraph (B), beginning January 1, 2016'';
                (ii) in subparagraph (A), as added by subparagraph (A) 
            of this paragraph, by inserting ``(referred to in this 
            subsection as the `reporting period')'' after ``at a time 
            specified by the Secretary''; and
                (iii) by adding at the end the following:
            ``(B) Revised reporting period.--In the case of reporting 
        with respect to clinical diagnostic laboratory tests that are 
        not advanced diagnostic laboratory tests, the Secretary shall 
        revise the reporting period under subparagraph (A) such that--
                ``(i) no reporting is required during the period 
            beginning January 1, 2020, and ending December 31, 2020;
                ``(ii) reporting is required during the period 
            beginning January 1, 2021, and ending March 31, 2021; and
                ``(iii) reporting is required every three years after 
            the period described in clause (ii).''; and
            (B) in paragraph (4)--
                (i) by striking ``In this section'' and inserting the 
            ``(A) In general.--Subject to subparagraph (B), in this 
        section''; and
                (ii) by adding at the end the following:
            ``(B) Exception.--In the case of the reporting period 
        described in paragraph (1)(B)(ii) with respect to clinical 
        diagnostic laboratory tests that are not advanced diagnostic 
        laboratory tests, the term `data collection period' means the 
        period beginning January 1, 2019, and ending June 30, 2019.''.
        (2) Corrections relating to phase-in of reductions from private 
    payor rate implementation.--Section 1834A(b)(3) of the Social 
    Security Act (42 U.S.C. 1395m-1(b)(3)) is amended--
            (A) in subparagraph (A), by striking ``through 2022'' and 
        inserting ``through 2023''; and
            (B) in subparagraph (B)--
                (i) in clause (i), by striking ``through 2019'' and 
            inserting ``through 2020''; and
                (ii) in clause (ii), by striking ``2020 through 2022'' 
            and inserting ``2021 through 2023''.
    (b) Study and Report by MedPAC.--
        (1) In general.--The Medicare Payment Advisory Commission (in 
    this subsection referred to as the ``Commission'') shall conduct a 
    study to review the methodology the Administrator of the Centers 
    for Medicare & Medicaid Services has implemented for the private 
    payor rate-based clinical laboratory fee schedule under the 
    Medicare program under title XVIII of the Social Security Act (42 
    U.S.C. 1395 et seq.).
        (2) Scope of study.--In carrying out the study described in 
    paragraph (1), the Commission shall consider the following:
            (A) How best to implement the least burdensome data 
        collection process required under section 1834A(a)(1) of such 
        Act (42 U.S.C. 1395m-1(a)(1)) that would--
                (i) result in a representative and statistically valid 
            data sample of private market rates from all laboratory 
            market segments, including hospital outreach laboratories, 
            physician office laboratories, and independent 
            laboratories; and
                (ii) consider the variability of private payor payment 
            rates across market segments.
            (B) Appropriate statistical methods for estimating rates 
        that are representative of the market.
        (3) Report to congress.--Not later than 18 months after the 
    date of the enactment of this Act, the Commission shall submit to 
    the Administrator, the Committee on Finance of the Senate, and the 
    Committees on Ways and Means and Energy and Commerce of the House 
    of Representatives a report that includes--
            (A) conclusions about the methodology described in 
        paragraph (1); and
            (B) any recommendations the Commission deems appropriate.

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