Medicare lab payment analysis raises questions about pricing transparency

Modern Healthcare: The MEF in question was created by Palmetto and contains the Medicare payment rates to labs (identifiable by NPI) for 22,000 lab tests (identifiable by CPT codes). Investment firm Nephron received the MEF from CMS, under FOIA, with the specific goal of pinpointing what the government was paying one lab, Myriad Genetics, for GeneSight, a multi-gene, combinatorial pharmacogenetic test that helps doctors understand how patients' genetic variations can impact their ability to respond to certain depression drugs. During an August earnings call, Myriad executives said that GeneSight was being reimbursed by Medicare at a new rate but declined to disclose the price.

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