Policy Analysis: Who Are the Winners and Losers if the 14-Day Rule Provision Survives?

Just last week the College of American Pathologists (CAP ) was joined by the American Hospital Association, the Association for Molecular Pathology (AMP), the Association of Pathology Chairs (APC), the Association of American Medical Colleges (AAMC), and the American Society for Investigative Pathology (ASIP) as cosigners of a letter to the Senate opposing a provision that would change current law with respect to payment for certain molecular laboratory tests that fall within the Medicare 14-day rule.
 
The rule pertains to blood or tissue samples collected by a hospital from patients while they are a hospital inpatient or outpatient. Under current Medicare regulations, if a laboratory performs testing on such a specimen within 14 days of a patient’s discharge, the laboratory performing the test must be paid by the hospital through its existing DRG, rather than a direct payment from Medicare.
 
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