Protecting Access to Medicare Act
Signed into law on April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) includes the most extensive reform of the Medicare Clinical Laboratory Fee Schedule (CLFS) since it was established in 1984. Section 216 of PAMA creates a new Section 1834A of the Social Security Act, which contains many of the CLFS…
Signed into law on April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) includes the most extensive reform of the Medicare Clinical Laboratory Fee Schedule (CLFS) since it was established in 1984. Section 216 of PAMA creates a new Section 1834A of the Social Security Act, which contains many of the CLFS reforms. Starting on January 1, 2017, most rates on the CLFS will be derived from private payor rates for laboratory services. PAMA also designates certain tests as “advanced diagnostic laboratory tests” (ADLTs); includes provisions affecting coding, coverage and oversight of the CLFS; and makes some changes to CMS’s review of mis-valued codes in the Physician Fee Schedule (PFS) affecting anatomic pathology services provided by laboratories.
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Leading Patient, Provider, Diagnostic and Laboratory Organizations Call on Congress to Protect Seniors from Medicare Lab Cuts
HHS’ flawed data collection system jeopardizes beneficiary access to critical lab services Washington, D.C. – With millions of Medicare beneficiaries facing year-over-year cuts to their Medicare lab access, more than 30 leading organizations representing patients, health care professionals, laboratories and diagnostic manufacturers urged Congressional leaders to take immediate action to prevent drastic reductions to beneficiaries’ care. The letter reiterates the serious concerns regarding theContinue Reading »... -
PAMA Stakeholder Letter to Congress
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Market-Based in Practice, Not Just Theory
One of the driving forces in today’s health system is the goal of promoting and maintaining a competitive market for patients. In a “market-based” health system, consumers see the direct benefit of labs competing on quality, cost and services available – rather than an arbitrary, one-size-fits-all approach that fails to achieve any of these goals. In fact, that was one of the prevailing incentivesContinue Reading »... -
ACLA Statement on HHS OIG Report Regarding PAMA Cuts & Data Collection
Washington, D.C. – Following the release of today’s report from the U.S. Department of Health & Human Services (HHS) and the Office of Inspector General (OIG) regarding laboratory data collection under The Protecting Access to Medicare Act of 2014 (PAMA), Julie Khani, President of the American Clinical Laboratory Association (ACLA), released the following statement: “Today’s OIG report skirts the central issue: that HHS deliberatelyContinue Reading »... -
ACLA Statement on Proposed 2019 Medicare Payment Changes
Proposed rule seeks input on how to improve data collection process; millions of seniors still at risk for continued cuts to essential Medicare lab services Washington, D.C. – Following the release of a proposed Medicare payment rule, The American Clinical Laboratory Association (ACLA) continues to raise concerns about the flawed implementation of the Protecting Access to Medicare Act (PAMA) that will lead toContinue Reading »... -
ACLA Letter Opposing House FY19 LHHS Appropriations Report Encouraging Review of Test Panel Reimbursement
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ACLA Statement to Senate Finance on Rural Health Care
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Recent NILA report highlights harmful impacts of misguided PAMA implementation on labs and seniors
A report recently published by the National Independent Laboratory Association (NILA), highlights the ways in which the Protecting Access to Medicare Act (PAMA) is undermining the nation’s clinical laboratory infrastructure. Specifically, the report demonstrates the harmful impacts the legislation has already had on community and regional labs across the country and the threats current PAMA implementation poses to seniors’ access to lifesaving clinical tests.Continue Reading »... -
ACLA Urges Summary Judgment from District Court on Lawsuit Against HHS
Lawsuit targets HHS’ unlawful implementation of 2014 Medicare legislation, regulation that would jeopardize beneficiaries’ access to critical lab services Washington, D.C. – With millions of Medicare beneficiaries facing potential shortages in critical laboratory tests and diagnostics, the American Clinical Laboratory Association (ACLA) continued the push for summary judgment in its lawsuit against the U.S. Department of Health and Human Services (HHS) for failing toContinue Reading »... -
ACLA Leads Clinical Laboratory Community in Urging CMS to Address State Medicaid Rate Cuts for Lab Services
(Washington, D.C.) – The American Clinical Laboratory Association (ACLA) along with a dozen clinical laboratory stakeholders sent a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma today urging her to discourage states from making cuts to Medicaid rates for lab tests. The letter notes that with the flawed implementation of the Protecting Access to Medicare Act (PAMA) significantly reducing MedicareContinue Reading »...
