ACLA is calling on Congress to pass the bipartisan, bicameral Saving Access to Laboratory Services Act (SALSA) to ensure patient access to laboratory testing services, protect the nation’s clinical laboratory infrastructure, and support innovation in testing to advance the next generation of personalized care. More than 60 patient, provider, and consumer organizations support this important legislation.
SALSA is critically needed to correct flaws in the implementation of the Protecting Access to Medicare Act (PAMA), passed by Congress in 2014 to reform the Medicare Clinical Laboratory Fee Schedule (CLFS). Congress intended for private market data collected from all types of laboratories, including hospital outreach laboratories, independent laboratories, and physician office laboratories to be the basis for CLFS payment rates. Unfortunately, the first round of data collection captured fewer than 1 percent of laboratories, artificially reducing laboratory test payments.
The result has been three years of up to 10 percent cuts for 75 percent of laboratory tests, amounting to $3.8 billion in payment reductions for the most commonly ordered test services for Medicare beneficiaries. Congress, on a bipartisan basis, has intervened three times to prevent further PAMA cuts. However, cuts of up to 15 percent will resume January 1, 2025, absent congressional action.
If imposed, these steep Medicare cuts for clinical laboratory services could reduce patient access to testing and impede research and innovation in the next generation of laboratory services that can improve and save lives. These cuts would also undermine the nation’s testing capacity and infrastructure that is critical in times of health emergency, day-to-day care, and essential to meeting the growing health care needs of the country, including in medically underserved communities.
SALSA would simplify the data collection process by providing the Centers for Medicare & Medicaid Services (CMS) with the authority to collect data from a statistical sampling of all major types of laboratories that provide services to seniors, including independent, hospital, and physician office laboratories. Targeted sampling, as designed by SALSA, is a straightforward solution to collecting complete representative private market data to achieve accurate and sustainable Medicare rates for laboratory services.
In the long-term, sustainable reimbursement for laboratory services will support strong clinical laboratory infrastructure to protect patient access and public health, while fostering innovation in tomorrow’s diagnostics to improve and save lives.
Join the Stop Lab Cuts campaign. Clinical laboratories along with many provider, patient, and consumer stakeholder groups are coming together to advocate for sustainable Medicare rates for laboratory services. The Stop Lab Cuts campaign advocates for passage of the Saving Access to Laboratory Services Act to ensure patient access to laboratory testing services, protect the nation’s clinical laboratory infrastructure, and support innovation in testing to advance the next generation of personalized care.
Visit StopLabCuts.org to learn more.
Updated November 2023
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