ACLA’s Legal Challenge of PAMA

One-Year Delay to Clinical Laboratory Payment Cuts Included in Congressional Spending Package

The American Clinical Laboratory Association (ACLA) commends the inclusion of critically needed relief from looming Medicare payment cuts to clinical laboratory services in the short-term spending package passed by Congress on Wednesday, November 15.

The bill provides a one-year reprieve from Medicare cuts of up to 15 percent for approximately 800 laboratory services that would have gone into effect in January 2024. ACLA remains focused on securing a long-term solution to years of reductions that will resume in 2025 through the enactment of the Saving Access to Laboratory Services Act (SALSA) in 2024.

“ACLA is grateful to Congress for including a short-term reprieve from Medicare laboratory payment cuts and data reporting as part of the stopgap funding bill. Resumption of year-over-year cuts would threaten patient access to quality clinical laboratory services, reduce investment in innovation for the next generation of diagnostics, and weaken the nation’s clinical laboratory infrastructure,” said ACLA President Susan Van Meter. “We are thankful to Senators Sherrod Brown (D-OH) and Thom Tillis (R-NC), and Representatives Richard Hudson (R-NC), Bill Pascrell, Jr. (D-NJ), Gus Bilirakis (R-FL), Scott Peters (D-CA), Brian Fitzpatrick (R-PA), Larry Bucshon (R-IN), Ann Kuster (D-NH), and Dan Crenshaw (R-TX), the bipartisan champions of the Saving Access to Laboratory Services Act (SALSA), and the dozens of co-sponsors across both chambers for ensuring cuts will not resume in January. The one-year delay is essential and in 2024 we will continue partnering with the 70 patient and provider organizations and the bipartisan and bicameral SALSA champions in Congress to advance SALSA as a sustainable, long-term solution to this problem.”

Medicare reimbursement for clinical laboratory services has been set on an unsustainable path of multi-year, double-digit reimbursement cuts resulting from the Protecting Access to Medicare Act of 2014 (PAMA), which relied on a narrow and unrepresentative sample to set Medicare reimbursement rates for hundreds of common laboratory tests. Since the enactment of PAMA, there have been three rounds of payment cuts of up to 10 percent that have impacted 72 percent of tests on Medicare’s Clinical Laboratory Fee Schedule.

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Thank you for your support of the Stop Lab Cuts Campaign.  We look forward to working with you in 2024!