CMS Publishes PFS Shocker: Agency Guts 88305 Reimbursements by 52 Percent;
Places New Molecular Pathology Codes on CLFS
Reimbursement for the Technical Component of 88305 will be reduced 52 percent and the 101 new molecular pathology codes will be assigned to the clinical laboratory fee schedule, the Centers for Medicare and Medicaid Services (CMS) announced when it published its CY 2013 Physician Fee Schedule (PFS) Final Rule today. The rule also outlines that PFS reimbursement rates will be cut 27 percent due to the impact of the flawed sustainable growth rate. It is widely expected, however, that Congress will take action to prevent the SGR-related cuts from going into effect. Read more

New York ASCP Members Score Victory in State Self Referral Rollback
Pathologists and other laboratory professionals in New York scored a major legislative victory in October when New York Gov. Andrew M. Cuomo vetoed legislation that would eliminate much of New York’s own Physician Self Referral Law. The measure, AB 3551, would have had the state follow the federal Stark Law, which is replete with loopholes that have encouraged self referral arrangements as clinicians increasingly try to profit on the medical services they order. Read more

CMS Provides Pathologists Temporary Relief from Meaningful Use Penalties
The U.S. Centers for Medicare and Medicaid Services (CMS) will shield pathologists, at least temporarily, from the Meaningful Use program’s noncompliance penalties that go into effect in 2015. The relief was provided as part of the agency’s Meaningful Use Stage Two Final Rule, released in late August at ASCP’s urging. The rule also provides protection for radiologists and anesthesiologists. Read more

Federal Appeals Court Upholds Earlier Gene Patent Ruling
Last month, a divided U.S. Federal Circuit Court of Appeals upheld its ruling that gives Myriad Genetics the right to patent BRCA 1 and BRCA2, two genes that are linked to increased rates of breast and ovarian cancer. The patents allow Myriad to be the exclusive U.S. commercial provider of screening assays for these genes, and permit the company to determine the terms and price for testing, making it impossible for women to access alternate tests or obtain a second opinion about their results. The patents also give Myriad the authority to prohibit researchers from investigating these genes without first gaining permission. Read more