The LAB Act would delay the upcoming PAMA reporting period to improve data collection processes and ensure sustainable, market-based rates for laboratory services
WASHINGTON, D.C. — Growing bipartisan support to protect seniors’ laboratory benefits reinforces the urgent need for Congress to immediately advance H.R. 3584 – The Laboratory Access for Beneficiaries (LAB) Act – a commonsense bipartisan bill that would take steps to mitigate the ongoing harm facing more than 53 million seniors who depend on vital clinical laboratory services.
Under the 2014 Protecting Access to Medicare Act (PAMA), Congress directed the Centers for Medicare and Medicaid Services (CMS) to establish market-based rates for clinical laboratory tests to ensure that millions of seniors could maintain access to critical health services. However, CMS disregarded congressional intent by collecting payment data from less than 1 percent of the nation’s laboratories to set Medicare reimbursement rates – leading to severe cuts for some of the most routine and critical lab tests for seniors.
Today, year-over-year cuts to Medicare lab services represent a real and urgent threat for millions of seniors and their families, with a new round of cuts – driven by unrepresentative data – slated for implementation January 1, 2020. If Congress fails to pass the LAB Act and delay the upcoming data reporting period (January 1 – March 31, 2020), the rates implemented January 2021 will be based on faulty data as well, further endangering seniors’ health.
Once fully phased in, cuts to clinical lab services will exceed more than 30 percent across a range of diagnostic tests. Even more concerning, laboratories serving seniors in nursing homes and rural communities disproportionately bear the brunt of cuts to clinical lab services, undermining a vital health care safety net.
The LAB Act, introduced by Rep. Scott Peters (D-CA), Rep. Gus Bilirakis (R-FL), Rep. Bill Pascrell (D-NJ), Rep. Kurt Schrader (D-OR), Rep. Richard Hudson (R-NC) and Rep. George Holding (R-NC) – now with 52 bipartisan cosponsors – would suspend the next round of PAMA data reporting for one year to ensure that all applicable laboratories required to report private payor data have the necessary time to do so. The bill would also commission a study by the National Academy of Medicine to provide recommendations on how to implement a less burdensome data collection process and appropriate rate-setting methodology that is representative of the market and ensures sustainable patient access, as Congress intended.
“We are encouraged by growing bipartisan support for the LAB Act and the recognition among policymakers about the urgent need to address PAMA this year,” said ACLA President Julie Khani. “Our number one priority is patient access. If Congress fails to pass the LAB Act in 2019, an unrepresentative data set will once again erode laboratory services starting in January 2021, compounding the harm facing seniors who depend on clinical laboratory diagnostics to manage, treat, and diagnose disease.”
To view the LAB Act, click here.