In 2014, Congress passed the Protecting Access to Medicare Act (PAMA). The Act was intended to, among other things, provide a predictable and reliable reimbursement standard for Medicare lab tests based on market data.
Unfortunately, when it comes to federal bureaucracies, nothing is predictable. The Department of Health and Human Services decided to “interpret” Congress’ direction to fit its own goals and convenience. So, rather than gather data broadly from the market as Congress intended, HHS cherry-picked cost data from less than 1% of laboratories. The result: HHS slashed Medicare payments for lab services for virtually all of the most commonly performed lab tests (such as tests for diabetes, cancer, and heart disease) and set in motion a chain reaction that will soon deprive many seniors of access to vital lab testing.
Sadly, because of HHS’ indefensible approach, the seniors most likely to suffer are the most vulnerable – those in nursing homes or in rural areas where it is most expensive to provide laboratory testing services. Already, labs serving these customers are cutting back.
Congress thought they had fixed a problem, but what they ended up doing was giving federal bureaucrats even greater power of seniors’ health care – a power they have unfortunately abused.
While Secretary Azar has inherited this mess, we hope that he will take the necessary steps to correct course and ensure that seniors don’t see their access to vital laboratory tests reduced.
The 60 Plus Association is leading a fight against this misguided policy and asking Congress to step in and direct HHS to follow the intent of the law. If you care about seniors’ access to vital lab tests or about stopping federal bureaucrats from making up their own laws, we hope you’ll join our fight. It’s time to stop the Medicare lab cuts.