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CMS Could Improve Its Procedures for Setting Medicare Clinical Diagnostic Laboratory Test Rates Under the Clinical Laboratory Fee Schedule for Future Public Health Emergencies

Submitting OIG: 
Department of Health & Human Services OIG
Date Issued: 
Tuesday, April 23, 2024
Agency Reviewed / Investigated: 
Department of Health & Human Services
Submitting OIG-Specific Report Number: 
A-01-21-00506
Component, if applicable: 
Centers for Medicare & Medicaid Services
Location(s): 
United States
Type of Report: 
Audit
Questioned Costs: 
$0
Funds for Better Use: 
$0
Number of Recommendations: 
2
Report updated under NDAA 5274: 
No
View Document: 
AttachmentSize
PDF icon CMS-Could-Improve-Doc.pdf1.77 MB
Additional Details Link: 
https://oig.hhs.gov/documents/audit/9856/A-01-21-00506.pdf

Related Open Recommendations

Recommendation Number Recommendation Status Significant Recommendation Additional Details
24-A-01-065.01 Open No
We recommend that the Centers for Medicare & Medicaid Services establish procedures to improve communication among all stakeholders involved in setting new CDLT rates during a PHE.
24-A-01-065.02 Open No
We recommend that the Centers for Medicare & Medicaid Services improve its procedures, which may require seeking legislative authority, for setting and adjusting rates for new CDLTs during a PHE by providing the MACs with the flexibility needed to set and adjust payment rates that would cover the laboratory costs of providing services when responding to a PHE.
Displaying 2 of 2 Recommendations