Statement from the American Clinical Laboratory Association on Medicare Physician Fee Schedule Final Rule

November 27, 2013 Categories: ACLA News, All News, Reimbursement and Coverage

Today the American Clinical Laboratory Association (ACLA) commends the Centers for Medicare & Medicaid Services (CMS) for not finalizing a proposal to slash Medicare payments for anatomic pathology services which diagnose breast, colon, prostate, skin, ovarian, leukemia and other cancers.

The proposal, included in the CY2014 Physician Fee Schedule Proposed Rule published in July, would have capped Medicare payments to independent laboratories to Hospital Outpatient Prospective Payment System (OPPS) levels, amounting to reductions of up to 80 percent for common anatomic pathology services. ACLA and its member companies, patients, pathologists, manufacturers and others raised serious concerns that this policy could jeopardize Medicare beneficiaries’ access to these important diagnostic services.

“We are grateful CMS has heeded the concerns of labs, pathologists, manufacturers, Members of Congress and patients who voiced strong opposition to the OPPS proposal,” stated ACLA President Alan Mertz.

ACLA greatly appreciates the leadership of U.S. Senators Johnny Isakson (R-GA) and Amy Klobuchar (D-MN) as well as U.S. Representatives Jim Gerlach (R-PA) and Bill Pascrell (D-NJ) who led House and Senate letters to CMS Administrator Marilyn Tavenner expressing their concerns with the OPPS proposal. ACLA also thanks the 113 Members of Congress and 38 Senators who joined their colleagues on these letters in opposition to the proposal.

While CMS is not finalizing the anatomic pathology proposal, the Final Rule does include a proposal to revise payments for codes under the Clinical Laboratory Fee Schedule (CLFS) due to “technological changes.” ACLA and other stakeholders submitted comments to this proposal, which was also included in the Proposed Rule, and strongly advocated for a clear and open process allowing input from labs, patients, manufacturers and others.

In response to the CLFS proposal, Mertz stated, “ACLA is carefully reviewing the Final Rule. We will continue to work with CMS and Congress on behalf of our membership and the Medicare patients they serve as changes to laboratory reimbursement are considered.”

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