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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Government’s Brief in ACLA v. Azar
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ACLA’s Motion for Summary Judgment in ACLA v. Azar
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ACLA Files A Motion for Summary Judgment Against HHS In ACLA v. Azar
Washington, D.C. — Following a favorable decision on a jurisdictional question issued by the U.S. Court of Appeals for the D.C. Circuit, the American Clinical Laboratory Association (ACLA) has filed a motion for summary judgment before the U.S. District Court for the District of Columbia challenging the flawed implementation of the Protecting Access to Medicare Act (PAMA) in the final rule promulgated by the U.S. DepartmentContinue Reading »... -
For Seniors in Rural Communities, Erosion of Lab Benefits is an Urgent Threat
One in four seniors in the United States lives in a rural area—a notable statistic considering the unique set of health challenges these communities face. Nearly 80% of rural America is “medically underserved,” according to the federal government. Seniors living in these parts of the country have far fewer options for care and are often required to travel significant distances just to get theContinue Reading »... -
National Health Organizations Call on Congressional Leaders to Delay Flawed Reporting Process Jeopardizing Seniors’ Access to Laboratory Care
LAB Act would delay PAMA reporting period in order to improve data collection process for market-based rates WASHINGTON, D.C. – With 53 million Americans facing steep year-over-year cuts to vital clinical diagnostics, 26 national groups representing patient, provider, diagnostic and laboratory organizations called on Congressional leadership to delay a flawed data collection process that continues to erode Medicare lab benefits for the country’s mostContinue Reading »... -
Reps. Peters, Bilirakis, Pascrell, Schrader, Holding and Hudson Introduce Bipartisan Legislation to Protect Seniors’ Lab Benefits, Improve Data Reporting Under PAMA
LAB Act (H.R. 3584) would delay PAMA reporting period in order to improve data collection process for market-based rates WASHINGTON, D.C. — With 53 million Americans facing steep year-over-year cuts to vital clinical diagnostics, the American Clinical Laboratory Association (ACLA), AdvaMed, the National Independent Laboratory Association (NILA) and the Point of Care Testing Association applaud new bipartisan legislation introduced to address a flawedContinue Reading »... -
New analysis challenges GAO Report’s assumptions on lab billing
A new analysis from Braid-Forbes Health Research exposes the Government Accountability Office’s (GAO) flawed assumptions about lab billing practices by presenting survey data on more than 20 million actual clinical laboratory claims. Braid-Forbes’ analysis of publicly available data demonstrates that the GAO’s claim – that labs are receiving “excess payments” by charging Medicare for individual component tests in greater numbers rather than charging reducedContinue Reading »... -
ACLA Files Reply Brief Ahead of Oral Arguments in ACLA v. Azar Appeal
HHS’ data collection process under PAMA disregards Congressional intent, jeopardizing lab access for millions of seniors Washington, D.C. – The American Clinical Laboratory Association (ACLA) filed a reply brief today ahead of oral arguments in the ACLA v. Azar appeal which has been scheduled for April 23, 2019. The brief reinforces ACLA’s argument that the U.S. Department of Health and Human Services (HHS) failedContinue Reading »... -
Leading Health Groups Challenge GAO’s Flawed Report on Medicare Lab Billing
Washington, D.C. – In response to broad and misleading claims in a recent Government Accountability Office (GAO) report, leading clinical laboratory, diagnostic and provider organizations challenged the agency on a number of recommendations that could lead to disruption to seniors’ access to critical laboratory diagnostics. The joint letter from AdvaMedDx, American Clinical Laboratory Association (ACLA), College of American Pathologists (CAP), National Independent Laboratory Association (NILA)Continue Reading »... -
Letter from Industry Stakeholders in Response to GAO Report on PAMA
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