A new round of Medicare cuts could be imposed at the end of the month unless Congress acts soon.
Clinical labs are pushing for Congress to avoid the cuts to Medicare reimbursements for diagnostic testing, but those changes are set to take effect at the end of January.
Why It Matters
There’s been ongoing discussions around how Medicare pays for lab tests. While the 2014 Protecting Access To Medicare Act pushed to make Medicare payments for lab testing more in line with what insurers pay, it’s often been difficult to enforce based on self-reported information from the labs.
What To Know
Lawmakers on the House Energy and Commerce Health Subcommittee are considering a new bill, the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act, which would implement a freeze on Medicare’s current lab testing payment rates.
The Centers for Medicare and Medicaid Services is working to collect private payment data to establish what these rates would be.
If passed, the new law would cap these rate cuts to 5 percent a year instead of the current 15 percent.
“It has become clear the law is not exactly operating as intended, and Congress has frequently modified or delayed aspects of this reform,” House Energy and Commerce Chair Brett Guthrie, a Kentucky Republican, said at a health subcommittee hearing this month.
If nothing changes, the new 15 percent cuts will go into effect at the end of January.
“Without any action from Congress, beneficiaries could soon see a reduction of up to 15 percent on over 800 tests that currently fall into the schedule,” Alex Beene, financial literacy instructor for the University of Tennessee at Martin, told Newsweek. “The bill, which is gaining bipartisan support, would look to halt some of these complications and cap Medicare reduction at 5 percent, while also adjusting some of the data reporting requirements that were viewed as not always fully capturing different segments of the clinical lab market in the past.”
What People Are Saying
Democratic Senator Raphael Warnock of Georgia, in a statement: “Access to quality clinical labs is essential to keeping our seniors living long, healthy lives. I’m proud to partner with my colleague Senator Tillis to put forward this legislative fix that will help ensure Georgia seniors will continue to have access to high-quality diagnostic services.”
Republican Senator Thom Tillis of North Carolina, in a statement: “It is critically important that seniors have uninterrupted access to innovative diagnostic tests. The Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act is a necessary step toward ensuring this access and supporting seniors’ health care needs. I’m proud to work with my colleagues to permanently fix flawed data collection and reporting methods which will allow Medicare beneficiaries to continue receiving quality and affordable lab services.”
What Happens Next
Medicare beneficiaries and lawmakers facing a deadline at the end of the month before the new cut rates are enacted.
“For beneficiaries who rely on these services, the cuts will have an impact, and as with other potential Medicare cuts in recent months, the hope is Congress will be quick to act and ensure they don’t occur,” Beene added.
Read the full article here
