Laboratory Services Payment Threatened Once Again

Extract

It is discouraging to have to report that the reimbursement for clinical laboratory services is once again the target of budget-cutting strategies, this time proposed by the Republican leadership in the US House of Representatives. Congressman Bill Thomas (R-CA), Chairman of the House Ways and Means Committee, has released details of the House Medicare Reform Plan that he hopes to pass in June 2002. The plan contains a long list of reforms and improvements to the Medicare program, including the beginnings of a prescription drug benefit for Medicare beneficiaries. Funding of the drug plan creates the need to save money somewhere else. Of most interest to the laboratory community is the provision that states “Clinical Diagnostic Laboratories: eliminate CPI increase until competitive bidding for these services takes effect.”

At the ASCLS/CLMA Legislative Symposium on March 18 and 19, 2002, the more than 80 attendees carried a strong message to House and Senate offices about the acute need for an increase in the Medicare fee schedule for clinical laboratory services to occur in fiscal 2003.

Laboratories have been ‘squeezed’ for many years by the payment policies of the outpatient Medicare program (Part B), and by those of managed care organizations. The Medicare Fee Schedule payments for outpatient laboratory tests have been frozen at the same level, without even a consumer price index (CPI) increase, for 9 of the past 13 years. The Balanced Budget Amendments of 1997 (BBA) imposed a five-year freeze on the fee schedule for fiscal years 1998 through…