Congress Delivers Key Legislative Victory

Publication Date: Jan 8, 2020

New Law a First Step Toward Reforming Lab Fee Schedule

ASCP is pleased to report that the Laboratory Access for Beneficiaries (LAB) Act was signed into law on December 20. The Act provides a one-year delay of the requirement that clinical laboratories report payment rate data to the Centers for Medicare and Medicaid Services (CMS), as required by the Protecting Access to Medicare Act (PAMA). The measure was included in the recent consolidated appropriations bill passed by Congress on December 19. ASCP and 32 other concerned organizations wrote Senate and House leaders on December 2 urging adoption of The Laboratory Access for Beneficiaries (LAB) Act (HR 3584).

The measure begins the process of addressing flaws in the pricing of the Medicare Clinical Laboratory Fee Schedule (CLFS). The legislation suspends next year’s mandatory data reporting requirement and requires a study to be conducted by the National Academies of Medicine on how best to implement the least burdensome data collection process that is necessary to establish accurate market rates for laboratory services. ASCP hopes the measure will pave the way for more robust data reporting by hospitals, which could help improve payment rates for services reimbursed under the CLFS. As private payer reimbursement is often tied to the CLFS, increases in the Medicare rates could affect other payment rates.

The new law pushes back the reporting of laboratory payment rate data by applicable clinical laboratories. CMS had previously set the data collection period as beginning January 1, 2019 and ending June 30, 2019, with mandatory data reporting beginning January 1, 2020 and ending March 31, 2020. CMS would have been required to establish a new, and presumably lower, fee schedule by January 1, 2021.

ASCP will be closely following the implementation of the new law, as well as the American Clinical Laboratories Association’s lawsuit against the U.S. Department of Health and Human Services.

Other articles in the January 2020 ePolicy News:

ASCP Calls for Elimination of Stark Pathology Exemption
CMS Should Expand NGS Coverage, ASCP Urges
ASCP Supports Opioid Workforce Act

To read more articles from ePolicy News click here.

hologic-corp