Clinical laboratories are reimbursed for providing services to Medicare beneficiaries using either the Physician Fee Schedule (PFS) or the Clinical Laboratory Fee Schedule (CLFS), depending on the nature of the service. In addition, clinical laboratories provide services to beneficiaries of other government programs such as Medicaid, TRICARE and the Federal Employee Health Benefit Plan (FEHBP),…
Clinical laboratories are reimbursed for providing services to Medicare beneficiaries using either the Physician Fee Schedule (PFS) or the Clinical Laboratory Fee Schedule (CLFS), depending on the nature of the service. In addition, clinical laboratories provide services to beneficiaries of other government programs such as Medicaid, TRICARE and the Federal Employee Health Benefit Plan (FEHBP), as well as commercial plans.
Lab reimbursement in many of these programs has been reduced in recent years, and in the case of the Medicare program, annual cuts are scheduled in current law not only as a result of sequestration, but also through annual cuts built into the Affordable Care Act.
While payments for lab services are being slashed, the costs associated with providing critical laboratory services - including labor, supplies, and transportation - continue to climb.
Although many labs have managed to navigate changes in markets and reimbursement and while still continually improving quality, continued arbitrary and severe payment reductions will result in reduced access to essential tests for critically ill patients, less innovation, more closures or consolidation of businesses, and more people out of jobs.
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Letter from Leading Provider Organizations on Passing the Saving Access to Laboratory Services Act
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ACLA and 33 Provider Organizations Urge Congress to Protect Americans’ Access to Essential Laboratory Tests
Washington, D.C. – The American Clinical Laboratory Association has joined with more than 30 health care provider organizations to urge House and Senate leadership to protect ... Read More -
ACLA Statement on Texas Court Ruling on Preventive Screening Coverage
Washington D.C. – The American Clinical Laboratory Association (ACLA) released the following statement in response to a Texas court striking down an Affordable Care Act (ACA) provision ... Read More -
ACLA Applauds Introduction of Bipartisan Bill to Protect Seniors’ Access to Critical Diagnostic Tests
Association Relaunches ‘Stop Lab Cuts’ Campaign Washington, D.C. – The American Clinical Laboratory Association (ACLA) today welcomed the bipartisan and bicameral introduction of the Saving ... Read More -
ACLA Comments on Attachments and Electronic Signatures Proposed Rule
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ACLA Comments on CMS Proposed Rule on Interoperability and Prior Authorization
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ACLA Responds to CMS RFI on National Directory of Healthcare Providers and Services
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ACLA Response to CMS RFI on “No Surprises Act” Requirements
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ACLA Response to CMS RFI on Strengthening Medicare Advantage
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ACLA Letters to CMS on Coverage for Monkeypox Testing