Congress urged to update Medicare laboratory payment system

Twenty-six organizations, including the AHA, today urged congressional leaders to enact the Saving Access to Laboratory Services Act (H.R.8188, S.4499), bipartisan legislation that would update Medicare’s payment system for clinical diagnostic lab services and reporting requirements for labs. The Protecting Access to Medicare Act of 2014 reformed the Medicare Clinical Laboratory Fee Schedule to a single national fee schedule based on private market data from laboratories that service Medicare beneficiaries, but significant under sampling led to nearly $4 billion in cuts to hospital, physician and other labs providing commonly ordered tests for Medicare beneficiaries. Without a solution to this problem, labs face another round of cuts of up to 15% in January, at a time when they “remain at the forefront of patient care and responding to public health disruptions and threats such as COVID-19,” the groups wrote.