Pascrell Introduces Protections for Senior Lab Services Facing Cuts
Beneficiary access threatened by misguided Medicare decision
Washington, DC, June 22, 2022
U.S. Reps. Bill Pascrell, Jr. (D-NJ-09), a member of the House Ways and Means Committee with purview over health care, Scott Peters (D-CA-52), Richard Hudson (R-NC-08), Kurt Schrader (D-OR-05), and Gus Bilirakis (R-FL-12) today introduced the Saving Access to Laboratory Services Act, or SALSA.
The legislation seeks to protect American seniors’ access to laboratory services that are threatened by Medicare payment cuts. These cuts may threaten access to critical testing for American’s seniors. Seniors with chronic conditions and those living in underserved areas could face the greatest challenges. In addition, the yearly cuts may result in physician offices no longer offering laboratory tests and independent laboratories being forced to close.
“Lab access for our senior neighbors may be more important now than at any moment in the recent past,” said Rep. Pascrell. “Prompt, full access to lab services is essential to protecting seniors suffering from heart disease, cancer, and other common conditions, and save our economy big bucks in prevention. Because of a misguided statutory reading by the Centers for Medicare and Medicaid Services (CMS), lab access and aid under Medicare face outrageous cuts that will kill seniors and hurt the Americans economy. We are teaming up now to halt these cuts so our neediest neighbors are protected.”
“If we've learned one thing over the course of the pandemic, it's the value of early diagnosis to successfully treat diseases," said Rep. Peters. "Seniors rely on access to laboratory services for essential screening, detection, and treatment for common medical conditions. SALSA is a bipartisan, commonsense solution that will ensure seniors can get the tests and treatments they need. After nearly a decade of threats to the diagnostics they rely on, seniors deserve the certainty this bill would provide.”
“As we saw during the COVID-19 pandemic, our clinical laboratories play a crucial role in our health care system, providing seniors with critical diagnostic services that offer earlier disease detection and access to tailored treatment, prevention, and care. The Saving Access to Laboratory Services Act (SALSA) would offer a much-needed lifeline to our labs and help remedy unintended payment cuts that could endanger lives. I am proud to lead this bipartisan, bicameral effort, and look forward to working with my colleagues to ensure continued and timely access to lab services for our seniors,” said Rep. Hudson.
“I am proud to join this bipartisan, bicameral effort to preserve access to laboratory services through a permanent solution to the flawed pricing data collection process currently in place,” said Rep. Schrader. “The Saving Access to Laboratory Services Act builds off the bipartisan work I have championed in previous Congresses, and sets forth an equitable solution to addressing steep, unsustainable cuts in reimbursements due to formulation of non-representative data. In doing so, this legislation will help ensure that seniors, rural Oregonians, and underserved communities can access critical lab services, particularly in their health provider’s office, while also establishing a more reliable market-based system.”
“Seniors deserve access to high quality medical care, which includes diagnostic laboratory services and other tests with the potential to save lives through early detection and individualized assessment of patient needs. Our bipartisan SALSA legislation will help ensure that continued access and I urge my colleagues to expedite its passage,” said Rep. Bilirakis.
Companion legislation has been introduced in the upper chamber by U.S. Sens. Sherrod Brown (D-OH) and Richard Burr (R-NC).
The Protecting Access to Medicare Act passed by Congress in 2014 was intended to align Medicare payment for clinical laboratories with prevailing private market rates. However, because of CMS’s flawed implementation of the statute, 72 percent of clinical laboratory tests have faced Medicare payment cuts.
Medicare clinical laboratory payments have been cut by nearly $4 billion since 2018 after only three years of cuts. Some of the most used lab tests, including tests for heart disease, diabetes, cancer, and many other conditions, have already received three years of ten percent cuts (amounting to almost 30%). The harms of Medicare cuts on clinical laboratories are compounded, as Medicaid and many commercial payers base their rates on Medicare payments.
Clinical laboratories play a significant role in American health care, with more than seven billion clinical lab tests performed in the U.S. each year. When a patient or provider receives the results from a clinical test, that information provides a path forward for life-saving treatment, prevention, and care. If these cuts remain in effect, clinical labs will be ill-equipped to continue offering the breadth of diagnostic services currently available and will have far fewer resources and flexibility to respond to the next public health crisis.
Although clinical laboratory tests account for less than three percent of total Medicare Part B spending, tests save time, costs, and lives by enabling earlier detection and prevention of disease. Each laboratory test provides essential data to guide health care decisions for a relatively small expenditure. Furthermore, clinical laboratories have played a critical role in diagnosing and monitoring COVID-19 infections during the pandemic, allowing the economy to stay open and saving lives.