Dive Brief:
- Congress has again deferred Medicare reimbursement cuts of up to 15% for clinical laboratory tests with the passage Wednesday of a short-term government funding bill.
- The appropriations bill pushes back by one year the implementation of Medicare payment rates scheduled to take effect in January for about 800 lab services.
- “We are pleased that Congress has delayed pending reductions, recognizing the harm repeated Medicare reductions would have on the nation’s health care system that relies on clinical laboratory testing every day to inform patient care,” Susan Van Meter, president of the American Clinical Laboratory Association, said in a Wednesday statement.
Dive Insight:
The Protecting Access to Medicare Act (PAMA) of 2014 tied laboratory payment rates to market data for diagnostic tests, resulting in three rounds of reimbursement cuts.
ACLA and other industry groups contend that PAMA relies on an unrepresentative sample of clinical laboratory test prices to set Medicare rates.
The latest reprieve for the lab services industry is the fifth time Congress has delayed the phase-in of the new payment rates for clinical laboratories, according to the ACLA.
“This is a welcome step to ensuring patients can continue to rely on timely and accurate diagnostic services,” Van Meter said.
Legislation called the Saving Access to Laboratory Services Act that aimed to reform the Medicare reimbursement process for lab tests has failed to gain traction in Congress.
“There is widespread and bipartisan recognition that long-term reform is urgently needed,” Van Meter said. “A sustainable reform of the Medicare payment system for clinical laboratory services is vital to protect and enhance patient care, foster innovation, and ensure the stability of clinical laboratories nationwide.”