Protecting Access to Medicare Act

In 2014, Congress passed the Protecting Access to Medicare Act (PAMA) to ensure millions of seniors could maintain access to critical health services, including laboratory tests. Yet, the U.S. Department of Health and Human Services (HHS) has taken a flawed and misguided approach to PAMA implementation, leading to severe cuts to the labs that over 56 million seniors rely on for their lab tests under Medicare.

By drastically cutting rates, including for many of the most commonly performed lab tests, HHS may threaten access to critical lab services for diagnosing and treating beneficiaries with diabetes, heart disease, liver disease, kidney disease, prostate and colon cancers, anemia, infections, opioid dependency and countless other common health conditions.

In an acknowledgement of the ongoing harm facing seniors, Congress has acted three times to “press the breaks” on the harm caused by PAMA.  The bipartisan 2019 Laboratory Access for Beneficiaries (LAB) Act initially delayed the second round of data reporting.  Congress acted twice more through the 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Protecting Medicare and American Farmers from Sequester Cuts Act in 2021 to not only, again, delay the data reporting, but also delay additional cuts to laboratories. These cuts to laboratories are scheduled to return on January 1, 2023 and may threaten access to testing for seniors and our most vulnerable populations.

Click here for a summary of CLFS reform provisions in PAMA.