Congress Passes LAB Act, Extends Diagnostics Data Reporting through 2021
Congress passed the Laboratory Access for Beneficiaries (LAB) Act as part of its end-of-year federal spending package. This is an important first step in correcting steep cuts to Medicare reimbursement for infectious diseases diagnostics and a critical victory for millions of Medicare beneficiaries who rely on access to clinical laboratory services for rapid care. Its passage could not have been achieved without the sustained advocacy of the IDSA and laboratory community, including an IDSA letter to Congress, two action alerts through which hundreds of IDSA members contacted their congressional representatives, and a stakeholder letter signed by 26 physician, medical and patient organizations.
These cuts, which in many cases will exceed 30%, do not reflect market-based payments as intended by Congress under the Protecting Access to Medicare Act. IDSA has long been concerned that continued reimbursement cuts for ID diagnostic tests caused by faulty PAMA implementation will ultimately harm patient care, public health and laboratory efficiency. The LAB Act delays the upcoming data reporting period and requires that CMS provide recommendations to Congress on less burdensome data collection methods and representative reimbursement rate calculations for diagnostic tests. Its passage will help alleviate the steep year-over-year cuts to clinical ID diagnostics and address the flawed data collection process that continues to erode Medicare lab benefits.
Hospital outreach and other laboratories governed by PAMA that would have owed data during the first quarter of this year will now report that data between Jan. 1 and March 31, 2021. Centers for Medicare and Medicaid Services has also ruled out reducing 2020 payment rates by more than 10% for clinical diagnostic laboratory tests that are not advanced or new; for 2021, 2022 and 2023, these rates will be reduced by no more than 15%.
IDSA will continue working with Congress, CMS, and the laboratory community to protect diagnostic innovation and patient access to care.