On March 27, 2014, the U.S. House of Representatives passed, without change, a bill for a one-year SGR "patch." The U.S. Senate is expected to vote on the bill on Monday, March 31.
The bill includes language that attempts to overhaul how clinical laboratories are paid for Medicare laboratory services. Following is a summary of the major provisions in relation to clinical laboratories:
NILA has been in discussions with congressional committees for over a year on how to improve the Medicare payment system in a way that does not disproportionately affect community and regional laboratories. NILA is not supportive of several of the provisions included in this legislation, and we’re continuing to engage lawmakers.
NILA is seeking clarification on whether the new legislation repeals the current final rule in effect by CMS, which allows the agency to examine and adjust current Medicare payment rates based on “technological change,” beginning in 2015.
There is no across-the-board cut included as part of the legislative plan. If the legislation passes in its current form, the CLFS will first be adjusted beyond current statutory adjustments (1.75% Obamacare cuts, productivity adjustments, sequester 2% cuts) in 2017.
When this passes, CMS will initiate a rulemaking process that is required to occur by June 30, 2015. If the legislation remains unchanged, laboratories will be able to engage CMS and others as this rulemaking process proceeds.
Please click here to view the House SGR legislation. The section on clinical laboratories begins on page 35 (section 216) and continues through page 58.