EXECUTIVE SUMMARY:
This final audit report points out that the Medicare Part B program is paying single test payment rates for chemistry tests commonly performed on automated laboratory equipment. Single tests payment rates are paid because the Health Care Financing Administration's (HCFA) guidelines regarding chemistry tests subject to paneling have not been updated to add tests as laboratory technology has advanced. We identified 10 tests which are appropriate for paneling, but are not on the list of chemistry tests that should be paneled. We recommended that HCFA update its guidelines by expanding the national list of chemistry panel tests to include the 10 automated chemistry tests identified by our audit. Savings to the Medicare program would total about 216 million annually as a result. We also recommended that HCFA establish a process whereby advances in technology and laboratory practices are periodically reviewed to further update the national list. The HCFA generally concurred with our recommendations.