ACLA Statement on MedPAC Report
WASHINGTON, D.C.— Following the release of MedPAC’s June report, ACLA President Julie Khani issued the following statement:
“Recognizing the flawed implementation of the 2014 Protecting Access to Medicare Act (PAMA) and its negative impact on clinical laboratories and the patients we serve, Congress passed legislation in 2019 requiring the Medicare Payment Advisory Commission (MedPAC) to review the methodology the Centers for Medicare and Medicaid Services (CMS) implemented for the private payer-based Clinical Laboratory Fee Schedule (CLFS) rates and report on the least burdensome data collection process that results in a representative sample of all laboratory market segments.
In its report released today, MedPAC found that sampling of private payer rates from independent laboratories, hospital laboratories and physician office laboratories (POLs) is feasible, would produce accurate, representative data while reducing burden and would correct current below-market Medicare rates. This finding validates concerns long expressed by the laboratory community that reimbursement reductions imposed as a result of a flawed data collection process are too extreme and have resulted in unsustainable below-market rates. Importantly, this finding also refutes CMS’s assertion that the inclusion of hospital rates would not materially change Medicare rates.
However, ACLA is deeply concerned with other aspects of MedPAC’s report, which stray outside the clear mandate by Congress and offer biased commentary that ignores the true value of innovative laboratory tests and the importance of robust and timely access for patients. ACLA strongly disagrees with these assertions.
PAMA has set laboratories on an unsustainable path. The first round of data collection resulted in three years of 10 percent annual cuts for the majority of the fee schedule, and with hundreds of tests facing an additional 15 percent cut in 2022, seniors are counting on Congress to enact the necessary reforms to establish a payment system that is truly representative of the market and supports continued innovation and access to critical laboratory services.”
The American Clinical Laboratory Association (ACLA) is the national trade association representing leading laboratories that deliver essential diagnostic health information to patients and providers. ACLA members are at the forefront of driving diagnostic innovation to meet the country’s evolving health care needs and provide vital clinical laboratory tests that identify and prevent infectious, acute and chronic disease. ACLA works to advance the next generation of health care delivery through policies that expand access to lifesaving testing services.