Case Studies

 

Pathology Test Developers Push Back on Unreasonable Reimbursement Reductions

When the Centers for Medicare & Medicaid Services proposed reductions to payments for critical diagnostic tests used to manage patients with cancer, our team brought together a coalition of diagnostics manufacturers and clinical laboratories to develop and implement a strategy to show CMS that its proposal was critically flawed and would result in serious limitations to patient access to these critical tests.  The coalition worked with a broad range of stakeholder groups including professional societies and patient advocacy groups and met with both Executive Branch and Congressional offices to explain the concerns and offer solutions.  CMS ultimately decided not to proceed with its proposal, and our consultants are now continuing efforts to develop consensus on a solution that will address CMS’ concerns, maintain patient access, and continue incentives to invest in this key area.