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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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 »... -
Patient care is put to the test as clinical laboratory services are hit with a one-two punch in rate cuts
From providing vital diagnostic screenings for a wide range of conditions, to playing a pivotal role in precision medicine, clinical laboratories are a crucial component of America’s health system that drive disease prevention and diagnosis and help guide treatment decisions for patient care. Congress enacted the Protecting Access to Medicare Act (PAMA) of 2014 to protect essential lab services by mandating a reform ofContinue Reading »... -
ACLA PAMA Lawsuit Complaint Against CMS
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ACLA Motion for Summary Judgment in PAMA Law Suit, ACLA v. Azar
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ACLA Letter to Missouri Medicaid Opposing Medicaid Rate Reductions
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CMS Ignored Congressional Intent in Implementing New Clinical Lab Payment System Under PAMA, ACLA Charges in Suit
(Washington, D.C.) – The government agency that runs the Medicare program failed to follow a congressional directive to implement a market-based laboratory payment system, thereby jeopardizing Medicare patients’ access to vital laboratory services, according to the American Clinical Laboratory Association (ACLA) in a lawsuit filed today against the Acting Secretary of the U.S. Department of Health and Human Services (HHS) in the U.S. DistrictContinue Reading »... -
ACLA to CMS: Overall Finalized Rates Still Fundamentally Flawed, Agency Must Halt Implementation
(Washington, D.C.) – The American Clinical Laboratory Association (ACLA) stepped up its call to the Centers for Medicare & Medicaid Services (CMS) to delay its flawed implementation of Congress’ efforts to modernize the Medicare clinical lab payment system and align payment rates with market prices in the Protecting Access to Medicare Act (PAMA). While ACLA acknowledged several modifications to the draft rates by CMSContinue Reading »...
