California Clinical Laboratory Association



CCLA Board MeetingThursday, May 18, 201710:00am – 12:30pm Meeting Minutes1. CALL TO ORDERMeeting called to order by Kim Leroux at 10:07am PST2. MEETING ATTENDEESLAST NAMEFIRST NAMECOMPANY NAMECasarezStaceyWest Pacific MedicalChhabraSeemaNeoGenomisFoyKristianCCLAFreemanAngelaLab CorpGriffinEmiluWest Pacific MedicalHoward LaurieLab CorpIkedaJoanneSpectraKellyKatrinaKoehlerJimGenomic HealthLanzolattaJeffPacific ToxicologyLerouxKimberlyCombiMatrix DiagnosticsLingenfelterTamieAgendiaLuyJo AnnAscent MarcantiBarbaraNeogenomicsNakamoto JonQuestNealKennethLaboratory CorporationNicholson RickWest Pacific MedicalOstadrahimiRanaPacific ToxicologyRamageJuliePfizerTalbotDebbieSonicVernuskyChristineQuest Diagnostics3. APPROVAL OF MEETING MINUTESApril Meeting MinutesMotion to approve, motion carried. Minutes approved as submitted. HOT TOPICSState Budget Update: May Revision: Governor indicated in January that revenues were down $6B. Looked at last year’s budget and looked for programs not implemented and pulled them back from consideration. After the April taxes came in, the May revision occurred last week. There was a slight improvement in income taxes and sales tax, with an extra $2.5B brought in, so now the budget is just short $3B, but evened out with no surplus and no shortfalls so January programs can now move forward, but still adding the need for fiscal restraint, due to a possible recession. We are in the longest recovery on record and federal level of input is a huge unknown. ACA is a huge unknown and all we can budget is using the status quo. Jennifer Kent the head of Health and Human Services has a budget at $100Band the impact of the repeal could be $25B, or 25% of her budget. The Oroville Dam needs major repairs at a cost of $275M and we don’t have a budget for that and will need federal funds. Prop 56 Tobacco tax, the governor is taking $1.5B from that tax which was to go to provider rate increases. They are not using the money as it was intended but now using for the rising cost of Medi-Cal. The provider groups are very upset since they funded most of the initiative for prop 56. The CMA has a new proposal to get provider rate increases. They propose taking on more Medi-Cal patients in exchange for higher provider rates. The final budget needs to be to the governor by June 15th, with very little changes expected.Efforts to forgive Medi-Cal recoupments: there is a delay in implementation to the proposed dates to take the recoupments. They are looking at the periods of July 2012- June 2015 and July 2015-February 2016, with a third one of July 2016-February 2017. The new rates were to be applied and the differences in claims to be what looks like a total of $36M, with the first wave to collect $23M, the second $10.8M, and the third, $3.8M. The CCLA is asking for forgiveness of the retroactive recoupments. The budget committee asked the department of health services of the cost it would take to undergo this collection process versus what they would collect. The department is still pushing to move forward with recoupment. Since the department is looking at a shortfall of $25B, they feel collecting makes sense. Kristi verified that 20% of the testing being performed in CA is still Fee for Service which affects this. Review of Legislative Status Report (LSR)*1st year of a 2 year session for bills introduced this year with over 1,000 bills in the assembly. All bills need to be in the next house by June 2nd.AB 658 (Waldron): Clinical Lab Fees Renewals suspension- this bill is moving through the assembly currently. There is a $20M surplus in the department from collection of lab licensure fees. The department can only operate at what it needs to function, not for profit. This bill would suspend labs paying lab licensure fees for 2 years to spend down the current surplus in the department. The suspension period would be 2018-2109 and would remain in effect until January 2020 than be repealed. We need letters of support from the labs. The CCLA office has letter templates to use with letters of support.AB 659 (Ridley-Thomas) this is in regard to Medi-Cal reporting rates to go from yearly to every 3 years which is what PAMA requires. We’re asking to report data from 2018 in March 2019 than the rates would be developed and effective July 2020 allowing the department time to analyze and program their computers. It would then go to every 3 years to report. The department changed the data submission form for Medi-Cal. They are trying to streamline the process and are asking for input from us so that they can finalize how the form for reporting is used. Not much data has been sent, and we think more data would be better. Only information on data submission is on their website and they sent no letter asking people to send in their data as requested. Kristi suggested they send a letter to let labs know they should be doing this, rather than relying on them to know to go check the website for information and comply. They only received 33 labs info the first year and 56 last years, with 123 reporting this year after sending the letters. They were looking at 396 different codes but now only making reimbursement changes to 4 codes total, with 3 of those codes being less than 10% cut and one at 11%cut. The new rates will be posted next month, but rates won’t be in database until August. May 26th the bill will come out of appropriations than to the assembly floor by June 2nd than to the Senate.Review of LSR: Bills being tracked are now ? way through and we will know what comes out in June.Medi-Cal enrollment of out of state labs: out of state labs with California State Licenses were being denied Medi-Cal eligibility although other out of state labs are enrolled. CCLA sent a letter asking if there was any policy change in the department and a request for a higher level meeting. They have now sent out an announcement on their provider bulletin allowing out of state labs and clarifying their position. Jeff Lanzalotta made a suggestion about looking at other states that are restrictive to out of state labs. Rana will write this up and send it to the CCLA offices to look into this area.PAMA Update: PAMA submissions are due at the end of the month. Lori Howard said the ACLA is re-drafting their letter so we will wait to see what it says before suggesting any action. They are trying to negotiate certain requirements including the Hospital labs as it should have in the first place, and moving forward with single site labs who can participate more easily. CCLA Lab PAC: it was asked the group to participate and support the efforts of the organization by contributing so we have money for our lobbyist to attend events with assembly members and senators who have a proven track record of supporting laboratory issues. 4. BUSINESS REPORTSTreasurer’s Report- Ken NealAs of May 16,2017, the balance is $160,472.71Membership 2017 Update: Still some labs outstanding in paying their fees. Letters were sent last week.Industry Developments: Jeff Lanzalotta asked about Hospital Lab versus Clinical Labs. He said there is a lawsuit against a lab called Sun Clinical Labs in Texas using the rural hospital fee schedules to get higher reimbursement. This is in the toxicology area. He said we can look at Health law 360 for more details on this practice. Annual Conference – The Westin, Costa Mesa- Nov. 1-3, 2017. The website is being updated to reflect the conference. We already have 3 sponsors. It was asked of the group to please reach out to all their vendors now and ask if they will participate. There was a suggestion made to have a panel at the conference on how to head off a CERT audit and other items related to MAC denials and qualification to order. 5. CLINICAL LABORATORY TECHNOLOGY ADVISORY COMMITTEE (CLTAC) – Meeting is next week6. MEDICARE CONTRACTOR ADVISORY COMMITTEE – Jonathan Nakamoto/Ken Neal June 287. CCLA MEDICARE COMMITTEE – Kim Leroux - the meeting was held the week before at Xifin. The adoption of G codes was discussed through Noridian but not standardized across all the MAC’s. Dr. Oaks just said, that’s how it is. Noridian indicated all their appeals are caught up and formal requests for appeals can now be made. The CERT issue was discussed with an increase in errors coming through Noridian and MAC’s including need for physician’s signature and intent to order. They are making this the labs responsibility to determine from chart notes whether the physician intended to order tests. ICD-10 codes not considered intent to order. 8. CCLA MEDI-CAL COMMITTEE – pushing forward with recoupments in July depending on our bill in June. We will not know the amount that they want back from each lab until they start taking it. The first claw back is 5% of the check until paid, but they can’t tell us what that amount or total is. Next one is the two 7 months periods also in July and they are collecting 100% of the check until paid. There is a phone number you can call if you need to do a hardship schedule.9. NEW BUSINESS: None ADJOURNMENTMeeting was adjourned at 12:15 PSTRespectfully Submitted, Julie RamageNext Meeting:Thursday, June 15, 2017Teleconference9:30am-11:00am ................
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