ASCLS - Idaho
Focus
I attended the ASCLS/CLMA/ASCP National Legislative Symposium in Washington, D.C. March 17 with visits to “The Hill” on March 18, 2008.
Competitive Bidding: The “Medicare Prescription Drug, Improvement and Modernization Act of 2003” requires the Secretary of the Department of Health and Human Services to conduct a Demonstration program on using competitive bidding for clinical laboratory services for non-patients. The Centers for Medicare and Medicaid Services (CMS) has begun a demonstration process in the greater San Diego area. This is referred to as a Metropolitan Statistical Area (MSA). Idaho will not be involved at this time; however, repercussions will be felt in the future. Essentially what will occur is this: laboratories will bid on 303 laboratory tests and the lowest bidder gets the business for three years for that MSA. Losers must then draw and send the laboratory work to the winning ( lowest-bidding) laboratory. Losing labs will not be reimbursed for non-patient Medicare services. Upon the completion of three MSA projects, this process could result in a new and much lower reimbursement fee schedule for all Medicare patients.
While in Senator Craig and Crapo's offices, I requested their co-sponsorship of S2099, which would repeal competitive bidding. On the House side, the bill is HR3453. I requested co-sponsorship for HR3453 from both Congressmen Simpson and Sali. These bills are attached to the June 30th, 2008 vote on Medicare. We will be watching this very closely. I have materials on this issue for anyone who is interested, including solutions discussed during the Symposium.
Recently, a Federal Court delayed implementation of the CMS Competitive Bidding Program in San Diego. A San Diego Federal judge ordered the injunction of the Medicare bidding program that threatens the well-being of both patients and laboratories. Author of bill HR3453, Nydia Velasquez, called competitive bidding "ill-conceived” and stated that this process would have compromised access to services for many Medicare recipients and put many laboratories out of business. In addition, she stated, "When it comes to medical services, quality is what matters-not size. CMS' pilot bidding program allows the government to pick and choose the winners and losers arbitrarily. That's unfair to small firms and bad for patients.” The ruling by the judge is subject to appeal by the U.S. Department of Health and Human Services, which means the program may still go forward. That makes the adoption of Velazquez' Community Clinical Laboratory Fairness in Competition Act (H. R. 353), all the more pressing. Her bill, introduced last August, calls for a full repeal of the CMS program. It has 40 bipartisan co-sponsors in the House and similar legislation, S2099, has been subsequently introduced in the Senate.
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