• About Us
      • Mission
      • Members
      • Board of Directors
      • Staff
      • Annual Meeting
    • Economic Impact
    • Issues
      • PAMA
      • Economic Impact of Clinical Labs
      • Protecting Access to Medicare Act
      • Laboratory Developed Tests
      • Reimbursement and Coverage
      • Patient Access to Lab Services
      • Value of Labs
      • IOAS Exception and Self-Referral
      • Regulatory Issues
      • Value of Health IT Data Standards
      • TRICARE Non-Coverage of LDTs
    • Take Action
    • News
      • ACLA Blog
      • ACLA Press Releases
      • Comments and Letters
      • ACLA In The News
    • Resources
      • CPT Committee
      • NGS NCD Work Group
      • Prior Authorization Work Group
    • Join Us
    • Home
    • Contact Us
    • ACLA 2020 Annual Meeting
ACLA
    • Home
    • Contact Us
    • ACLA 2020 Annual Meeting
  • About Us
    • Mission
    • Members
    • Board of Directors
    • Staff
    • Annual Meeting
  • Economic Impact
  • Issues
    • PAMA
    • Economic Impact of Clinical Labs
    • Protecting Access to Medicare Act
    • Laboratory Developed Tests
    • Reimbursement and Coverage
    • Patient Access to Lab Services
    • Value of Labs
    • IOAS Exception and Self-Referral
    • Regulatory Issues
    • Value of Health IT Data Standards
    • TRICARE Non-Coverage of LDTs
  • Take Action
  • News
    • ACLA Blog
    • ACLA Press Releases
    • Comments and Letters
    • ACLA In The News
  • Resources
    • CPT Committee
    • NGS NCD Work Group
    • Prior Authorization Work Group
  • Join Us

ACLA Blog

Market-Based in Practice, Not Just Theory

July 26, 2018 Categories: ACLA Blog, Protecting Access to Medicare Act, Featured News

One of the driving forces in today’s health system is the goal of promoting and maintaining a competitive market for patients. In a “market-based” health system, consumers see the direct benefit of labs competing on quality, cost and services available – rather than an arbitrary, one-size-fits-all approach that fails to achieve any of these goals. In fact, that was one of the prevailing incentives in passing the Protecting Access to Medicare Act (PAMA) which ended the year-over-year uncertainty and disruptions to seniors’ access to critical Medicare services, including laboratory tests and diagnostics.

Which is why clinical laboratories are urging the Administration to reverse a misguided reimbursement system for lifesaving diagnostics and clinical tests that is far from a market-based model. While Health and Human Services (HHS) Secretary Alex Azar will focus this week on the importance on market-based approaches to patient care, the Administration can put its rhetoric into reality by advancing the right type of policy changes that will improve seniors’ care.

Currently, millions of seniors are facing roughly $670 million in cuts to their Medicare lab benefits and services – and more cuts are on the way over the next two years. The cuts are a direct result of HHS’ flawed, backwards approach to implementing PAMA. While Congress directed the Department to collect data on private market payment from a broad range of labs, the Department of Health and Human Services (HHS) cherry-picked data from less than 1 percent of labs across the country to determine rates for the new Medicare Clinical Laboratory Fee Schedule (CFLS).

By ignoring reimbursement data from more than 99 percent of labs, HHS is following a CFLS that completely fails to reflect the full clinical laboratory market, leading to extreme cuts to vital lab services and jeopardized care for the most vulnerable Medicare beneficiaries. A recent report from National Independent Laboratory Association (NILA) found that these cuts are leading to widespread reductions in laboratory services, including house-calls to homebound seniors and 24-hour emergency STAT testing, and access to labs in rural communities.

ACLA recently filed a lawsuit against HHS against this flawed approach that harms and jeopardizes patients. When Secretary Azar touts the benefits of a market-based approach to care, he can put his words into action by preventing the cuts to seniors’ lifesaving lab services.

Print page / Save as PDF

News

  • Press Releases
  • Letters and Comments
  • ACLA in the News

Issues

  • Economic Impact of Clinical Labs
  • Protecting Access to Medicare Act
  • Laboratory Developed Tests
  • Reimbursement and Coverage
  • Patient Access to Lab Services
  • Value of Labs
  • Regulatory Issues
  • Value of Health IT Data Standards
  • TRICARE Non-Coverage of LDTs

Fact Sheets

  • Value of Labs
  • Threats to Lab Services
  • Impacts of HHS’ Cuts to Lab Services

Media Contact

Grace Montgomery
Phone: (202) 499 2050
Email: press@acla.com

Back To Top

menu1

  • Economic Impact of Clinical Labs
  • Value of Lab Testing
  • Take Action
  • Join Us
  • Members
  • Contact Us

About Us

  • Mission
  • Members
  • Board of Directors
  • Staff
  • Annual Meeting

Issues

  • Economic Impact of Clinical Labs
  • Protecting Access to Medicare Act
  • Laboratory Developed Tests
  • Reimbursement and Coverage
  • Patient Access to Lab Services
  • Value of Labs
  • Regulatory Issues
  • Value of Health IT Data Standards
  • TRICARE Non-Coverage of LDTs

News

  • ACLA In The News
  • ACLA News
  • ACLA Press Releases
  • Comments and Letters
  • ACLA Blog

Address

202-637-9466
American Clinical Laboratory Association
1100 New York Ave, NW, Suite 725 West
Washington, DC 20005 USA
ACLA