The House Committees on Ways and Means and Energy and
Commerce began consideration of the latest draft Medicare Reform
legislation this week. The current draft preliminarily indicates
a major victory for clinical laboratories. There are no provisions
to extend the freeze on the Consumer Price Index (CPI) update
for clinical laboratory services, and implementation of competitive
bidding has been reduced to a demonstration project and is not
tied to any reduction in fees. This positive outcome is a direct
result of the advocacy efforts of the laboratory community through
the Clinical Laboratory Coalition, of which CLMA is an active
participant. Through letters and meetings with key members of
Congress on both Ways and Means and Energy and Commerce, the
importance of the CPI update and the problems with competitive
bidding for laboratory services were heard loud and clear.
The provision requiring the demonstration project on the application
of competitive contracting to clinical diagnostic laboratory
tests would be limited to colorectal cancer screening tests
and to tests “furnished without a face-to-face encounter between
the individual and the hospital or physician ordering the tests.”
An initial report to Congress on the project is due no later
than December 31, 2004.
A third provision affecting clinical laboratories has been
added to the latest draft. This new provision requires that
no later than 18 months after enactment of the legislation,
the General Accounting Office will submit a report for Congress
that analyzes differences in reimbursement between public and
private payors for clinical diagnostic laboratory services.
The details of that analysis and the opportunity for stakeholder
input have yet to be determined.
The committees are expected to produce two versions of the
bill with minor differences. The provisions referred to above
are contained in a draft to be considered by the Ways and Means
Committee. Expected changes in the Energy and Commerce version
are possibly the elimination of Medicare + Choice and competitive
contracting. It is unclear at the time of this alert whether
the provisions relevant to clinical laboratories will be in
the Energy and Commerce version of the bill. The goal is to
have a bill considered on the House floor prior to the July
4 congressional recess.
Contact for content: Katharine I. Ayres, Director of Health
Care Policy, kayres@clma.org. |
