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For patients, PAMA reforms can’t wait

January 22, 2019 Categories: ACLA Blog, Protecting Access to Medicare Act, Featured News

As we gaveled in a new Congress this month, protecting lab services for America’s seniors has never been more important.

A recent piece in the Washington Post is the latest example of the value of essential lab services in early diagnosis and treatment of some of the most complex, serious health conditions facing patients – a critical element in our broader efforts to address the health disparities facing millions of Americans. The article highlighted 73-year-old James Lyles’s experience with the PSA test, one of the many important diagnostic tools to identify prostate cancer in its early stages. After his primary care doctor recommended it as part of a routine screening, Lyles’s test results showed that he did, in fact, have cancer.

“It only takes a vial of blood to tell you whether your health is in jeopardy or not,” Lyles told the Washington Post. “It’s one of the easiest ways of finding out the truth about your body.”

Ensuring that patients have access to recommended tests and diagnostics can avoid costly, extensive treatments from undiagnosed, serious health conditions. Undiagnosed health conditions cost the U.S. health system billions, an expenditure that could be significantly reduced through early prevention and diagnosis through lab testing. But patients – especially seniors like Lyles – are bearing the brunt of the Medicare agency’s flawed implementation of the Protecting Access to Medicare Act (PAMA). With patients facing year-over-year cuts to essential lab services, it means the PSA test and other diagnostics that make it possible to identify cancer early on are much harder to access.

In 2018, Medicare beneficiaries endured an estimated $670 million in cuts to lab tests and diagnostics as a result of the Department of Health and Human Services (HHS’) misguided implementation of PAMA. Moving into 2019, this flawed approach to collection of Medicare lab reimbursement data continues to threaten access to lifesaving services for our most vulnerable populations, inevitably leading to reduced access to testing.

In fact, these cuts have already resulted in lab closures, reduced service hours, and limited access to tests for chronic diseases, putting seniors’ health at serious risk. Congress must address this important reality: continuing to slash essential lab services—over and over, year after year—can’t be sustained without consequences for patient care. Ultimately, cuts to Medicare lab access is penny-wise and pound-foolish when these tests can keep healthcare costs in check over the long-term.

Lab tests are lifesaving tools that need to be available to patients, particularly older Americans. As we welcome a new Congress to Washington, lawmakers must work to protect access to vital lab tests so that all seniors have a fighting chance against disease.

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