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, due to misguided implementation, PAMA has led to severe year-over-year cuts to the lab tests that over 56 million seniors rely on under Medicare. Between 2017 and 2022,…
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, due to misguided implementation, PAMA has led to severe year-over-year cuts to the lab tests that over 56 million seniors rely on under Medicare.
Between 2017 and 2022, payment for common tests for diseases like diabetes, cancer, and heart disease were cut by 27 percent. The next round of Medicare cuts, scheduled to begin January 1, 2023, would slash reimbursement up to another 15 percent for more than 800 laboratory tests, resulting in a staggering 41 percent cut to tests that are widely used to screen and manage many serious diseases. Collectively, these cuts may threaten access to laboratory services for diagnosing and treating seniors across the country.
Without congressional action this year, a fourth round of Medicare cuts are scheduled to begin in January 2023 that could jeopardize access to many clinical laboratory tests used to diagnose, monitor, prevent, and manage common diseases for seniors and all patients across the country.
It is essential that Congress protect patients by acting to fix the Medicare payment model for clinical diagnostic tests. The solution to reforming PAMA is the Saving Access to Laboratory Services Act (SALSA / S. 4449 / H.R. 8188). Congress has acted three times to delay these cuts in recent years, but permanent reform is needed now. The Saving Access to Laboratory Services Act would set Medicare reimbursement back on a sustainable path by updating Medicare’s payment system, which will help protect access to clinical laboratory testing, support investment in innovation, and strengthen America’s clinical laboratory infrastructure.
Click here to visit StopLabCuts.org and learn more about the Saving Access to Laboratory Services Act.
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HHS OIG Data Brief – Medicare Payments for CDLTs in 2014: Baseline Data
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HHS OIG DATA BRIEF
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ACLA PAMA Written Statement
August 4, 2014 Mr. Glenn McGuirk Center for Medicare Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, Maryland 21244 Dear Mr. McGuirk, The ... Read More -
ACLA Comments to CMS: Major Overhaul of Medicare Rates for Lab Services Should Be a Collaborative and Transparent Process
WASHINGTON, DC – The American Clinical Laboratory Association (ACLA) in public comments presented to the Centers for Medicare & Medicaid Services (“CMS”) today, provided input ... Read More -
ACLA, AdvaMedDx, and The Coalition for 21st Century Medicine Joint PAMA Implementation Letter to CMS
June 23, 2014 Ms. Anne E. Tayloe Hauswald, Director Division of Ambulatory Services Center for Medicare Centers for Medicare and Medicaid Services 7500 Security Boulevard ... Read More -
PAMA Implementation Letter to CMS Division of Ambulatory Services Director
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PAMA Statute, Section 216