ASCLS - IDAHO FOCUS

ASCLS Legislative Symposium 2010
Debbie Shell, ASCLS-Idaho Government Affairs Chair

The 2010 ASCLS Legislative Symposium, co-sponsored by ASCLS, CLMA, ASCP, and AMT, was held March 15-16 in Washington, D.C. A primary focus was health care reform, as the Symposium was held just 6 days before the House vote to pass health care reform legislation. The Capitol steps were alive with demonstrators dressed in elaborate costumes, many carrying signs, and many shouting opinions on the issue.

The primary issue discussed for laboratories was Medicare reimbursement for laboratory tests via the fee schedule. This process of reimbursement was implemented in 1984, and has never had a significant revision. Today, clinical laboratories are paid only 75% of the 1984 level when adjusted for inflation, and this fee schedule does not reflect changes in cost, technology, complexity, and delivery of laboratory services.

The Clinical Laboratory Coalition, of which ASCLS is a member, has proposed that the fee schedule be moderniiized to reflect appropriate reimbursement for each test and technology. The Institute of Medicine (IOM) in a 2000 report, and the Centers for Medicare and Medicaid (CMS) have both cited the need for a revision in the way Medicare laboratory tests are reimbursed. House Bill 1452 was originally proposed in 2008, with 6 Republican and 6 Democratic co-sponsors. This legislation would modify the way laboratory tests are paid for by Medicare, and would include a provision for annual review and revision as necessary
One proposed segment of the lab fee schedule modernization is updating the Medicare specimen collection fee. In 1984, Section 1833(h) of the Social Security Act established: “a nominal fee to cover appropriate costs in collecting the sample on which a clinical diagnostic laboratory test was performed.…”. The fee was initially set at $3.00 per draw. Since its inception 26 years ago, the fee has never been adjusted, even for inflation. As we all know, the cost of obtaining quality specimens has increased dramatically since 1984, regardless of inflation.
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