HHS’ flawed data collection system jeopardizes beneficiary access to critical lab services
Washington, D.C. – With millions of Medicare beneficiaries facing year-over-year cuts to their Medicare lab access, more than 30 leading organizations representing patients, health care professionals, laboratories and diagnostic manufacturers urged Congressional leaders to take immediate action to prevent drastic reductions to beneficiaries’ care.
The letter reiterates the serious concerns regarding the flawed implementation of the Protecting Access to Medicare Act (PAMA). When Congress passed PAMA in 2014, the legislation directed CMS to collect private payor payment rates in order to establish a fair and predictable market-based payment system for clinical laboratories. Instead, CMS collected data from less than 1 percent of laboratories nationwide. By excluding more than 99 percent of the nation’s laboratories, CMS violated the statute and undermined Congress’s goal of protecting beneficiaries and supporting value-based care delivery.
Reducing access to clinical lab services will ultimately drive up the cost of care for patients and taxpayers. This is particularly the case for millions of Americans who are managing diabetes, heart disease, liver disease, kidney disease, prostate and colon cancers, anemia, infections, opioid dependency, and countless other common diseases and conditions, particularly because they rely heavily on access to these routine lab tests to prevent costly interventions.
As the letter notes, “These cuts will force laboratories serving the most vulnerable and homebound patients to either shut down operations, eliminate tests, lay off employees, and reduce services for patients. In fact, according to a study by the National Independent Laboratory Association, within the first six months of the new rates going into effect, laboratories have reported cutting staff, limiting—or ending—testing services such as home care visits, and reducing the frequency of services to skilled nursing facilitates—leaving no option for the most fragile patient populations.”
To view the full letter, click here.
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ACLA is a not-for-profit association representing the nation’s leading clinical and anatomic pathology laboratories, including national, regional, specialty, hospital, ESRD and nursing home laboratories. The clinical laboratory industry employs nearly 277,000 people directly and generates over 115,000 additional jobs in supplier industries. Clinical laboratories are at the forefront of personalized medicine, driving diagnostic innovation and contributing more than $100 billion to the nation’s economy.