Competitive Bidding

Extract

One of the provisions of the Medicare Modernization Act of 2004 (MMA) was a Congressional mandate for the Center for Medicare and Medicaid Services (CMS) to conduct a competitive bidding project for clinical laboratory services. Many may remember that this is a project which has been proposed several times over recent years, but no demonstration has been conducted for the laboratory. (A demonstration was conducted for durable medical equipment – DME.) It has been our impression in past years that CMS was somewhat reluctant to hold the laboratory demonstration.

ASCLS has vigorously opposed the concept of competitive bidding for laboratory services, holding that laboratory tests are services, not commodities. Quality and access are important features of laboratory testing and as important, or more important, than price. ASCLS members have carried this message to Capitol Hill during many years of Legislative Symposium visits.

To comply with the MMA legislation, CMS has appointed a director of the project and hired a contractor, Research Triangle Institute, to plan and conduct the bidding process. An initial report was due to Congress by December 31, 2005. CMS held an Open Door Forum in August to unveil the conditions for the bidding and listen to questions and feedback from the laboratory community.

The purpose of the demonstration is twofold:

• To determine whether competitive bidding can be used to provide Part B clinical laboratory services at fees below current Medicare reimbursement rates while simultaneously maintaining quality and access to care

• To gain valuable information on the relative…