Today, Rep. Scott Peters (CA-52) introduced the bipartisan Laboratory Access for Beneficiaries (LAB) Act with his colleagues, Reps. Richard Hudson (NC-08), George Holding (NC-02), Bill Pascrell (NJ-09), Kurt Schrader (OR-05), and Gus Bilirakis (FL-12). This bill directs the National Academy of Medicine (NAM)—in consultation with the Centers for Medicare and Medicaid Services (CMS)—to conduct a study and make recommendations to improve how CMS collects data on lab reimbursements for life-saving lab services. In addition to the NAM-CMS study, the LAB Act will delay the next round of data reporting for one year, giving both CMS and labs additional time to collect complete and accurate data. Without a broad and representative collection of data, CMS’s current reimbursement methodology could underpay for lab services. This could cause small labs in rural locations to close, leaving seniors without a lab close to them and potentially higher costs for critical testing.

In 2014, Congress passed the Protecting Access to Medicare Act (PAMA), which directed CMS to establish reimbursement rates for lab services based on rates paid by private health insurers. CMS must adjust these payment rates every three years, based on the data labs collect and report during a six-month period. This ensures that Medicare pays close to a market rate for lab reimbursements, saving the government and taxpayers money. However, in 2018, when the first round of cuts went into effect, the Office of the Inspector General (OIG) raised concerns about the completeness and accuracy of the data CMS used to set payment rates. The LAB Act does not change the cuts scheduled to go into effect in 2020 under PAMA.

“Seniors have different health care needs, and diagnostic testing is one of the most effective ways to individualize care. We must preserve seniors’ access to this vital testing and ensure CMS pays competitive rates for the lab work, which saves taxpayers money,” said Rep. Peters.

“The ongoing cuts to clinical labs hurt patient access and cause further barriers to care,” said Rep. Pascrell. “So I am pleased to introduce legislation that will ensure payment rates under the Clinical Lab Fee Schedule will reflect market prices and that data collection will be representative of the whole laboratory community. Clinical laboratory services account for less than two percent of Medicare fee-for-service spending, but the results of laboratory tests help guide critical decisions for diagnosis, treatment, and prevention for millions of patients. We must ensure that there are no barriers to this critical resource so that we are improving health care for patients every day.”

“Seniors deserve access to high-quality medical care, which includes diagnostic tests which can save lives through early detection and individualized assessment of need.  Our bipartisan legislation will help to ensure that continued access and I urge my colleagues to expedite its passage,” said Rep. Bilirakis. 

“I am proud to be an original cosponsor of the Laboratory Access for Beneficiaries (LAB) Act which would help ensure that in-office laboratory testing remains financially viable for providers to offer and patients to receive” said Representative Schrader. “Onsite testing in a doctor’s office helps to make sure that patients are receiving the best care possible and are able to address their health issues in a single visit. The LAB Act assists the Centers for Medicare and Medicaid Services in appropriately reimbursing for these life-saving tests, while ensuring the highest standard of care for patients,” said Rep Schrader.

“Labs provide seniors critical diagnostic services they rely on to catch diseases early and provide tailored treatments. Unfortunately, these life-saving tests are facing massive unintended cuts that could endanger lives. This legislation is an important first step to reforming the current and get on the right path that Congress intended in 2014,” said Rep. Hudson.