In 2014, Congress passed the Protecting Access to Medicare Act (PAMA) to direct the Centers for Medicare and Medicaid Services (CMS) to develop a market-based methodology for determining the future rates Medicare will pay for tests under the Clinical Laboratory Fee Schedule (CLFS). To date, CMS has collected data from laboratories nationwide who were required to report private payer rates under the PAMA regulations. However, there is widespread concern that the data is fraught with inaccuracies.
The value of near patient testing is proven. It reduces costs and improves the care patients receive.
Despite these concerns, CMS released the preliminary rate determinations on September 22, 2017 and cuts in routine tests that physicians use every day to diagnosis and treat patients will be even more than projected. Fortunately, physician organizations, led by the American Medical Association, are now lobbying Congress and CMS to ensure that patients continue to receive the benefits of patient testing clinical laboratory testing in their community.