WASHINGTON, D.C. – Ahead of a crucial deadline to safeguard seniors’ access to lifesaving clinical laboratory services, Sen. Richard Burr (R-NC) and Sen. Sherrod Brown (D-OH) introduced the Laboratory Access for Beneficiaries (LAB) Act, bipartisan legislation to address critical data collection deficiencies resulting in year-over-year cuts to Medicare lab benefits.
Like its counterpart in the House of Representatives (H.R. 3584), the Senate bill (S. 3049) would delay the upcoming flawed data reporting process that is responsible for millions of seniors losing access to laboratory services.
The introduction comes amid a growing chorus of concern about the harm facing Medicare beneficiaries who are highly dependent on routine lab tests for their health. Last week, more than 30 leading health organizations, including the American Clinical Laboratory Association (ACLA), urged congressional leadership to advance the LAB Act as part of “must pass” end-of-the-year legislation to protect seniors from continued erosion of their lab benefits.
These ongoing cuts are a direct result of the Centers for Medicare and Medicaid Services (CMS) ignoring congressional direction in implementing the 2014 Protecting Access to Medicare Act (PAMA). The law directed CMS to establish a new market-based system for laboratory reimbursement, yet the agency only collected payment data from less than one percent of the nation’s labs – excluding the overwhelming majority of the market. This unrepresentative sample of laboratory rates consequently resulted in staggering year-over-year cuts to the routine tests that seniors rely on to manage diabetes, heart disease, cancer and countless other chronic conditions.
A new round of cuts – informed by incomplete data – is already slated for implementation January 1, 2020. If Congress fails to pass the LAB Act and delay the upcoming data reporting period (January 1 – March 31, 2020) before the end of the year, CMS will undoubtedly repeat the same flawed data collection process. As a result, rates implemented January 2021 will be based on unrepresentative data as well.
In addition to suspending the upcoming data reporting period, the LAB Act would also call for a nonpartisan study to provide recommendations on how best to implement a revised data collection process and rate-setting methodology. Together, these core reforms would support a market-based reimbursement system for laboratory services and maintain seniors’ access to vital Medicare benefits, as Congress originally intended.
“Make no mistake about it, the faulty implementation of PAMA has resulted in severe consequences for Medicare beneficiaries who depend on clinical laboratory diagnostics to manage, treat and diagnose disease,” said ACLA President Julie Khani. “We’re grateful to Sens. Burr and Brown for introducing the LAB Act and standing up for seniors across the country. It’s vital that we secure access to these lifesaving tests and continue to safeguard seniors’ health.”
# # #
ACLA is a not-for-profit association representing the nation’s leading clinical and anatomic pathology laboratories, including national, regional, specialty, hospital, ESRD and nursing home laboratories. The clinical laboratory industry employs nearly 295,000 people directly, and generates over 117,000 additional jobs in supplier industries. Clinical laboratories are at the forefront of personalized medicine, driving diagnostic innovation and contributing more than $106 billion to the nation’s economy.