The CAP and members of a laboratory coalition strongly urged congressional leaders to protect payment for clinical laboratory services by supporting the bipartisan and bicameral Saving Access to Laboratory Services Act (SALSA). The SALSA legislation would address the CAP’s concerns with clinical laboratory payment rates because of PAMA. Citing adverse impacts on laboratories and patients, the CAP advocates for improvements to how the Centers for Medicare & Medicaid (CMS) collects data from laboratories and stops next year’s 15% payment cut to more than 800 clinical laboratory tests. Absent congressional intervention, laboratories face a 15% cut in January of 2023. This will limit payment reductions in 2023 to 0%; to 2.5 in 2024, and for 2025 and each subsequent year, any reductions would be limited to 5%.

The CAP joined in this effort to urge Congress to act on PAMA reform to protect patient access to laboratory services.

In the August 15 letter, the coalition urged congressional leadership to pass the SALSA act as a “permanent solution that would set Medicare reimbursement for laboratory services on a sustainable path forward. SALSA will give the CMS new authority to collect private market data through statistically valid sampling from all laboratory segments for the widely available test services where previous data collection was inadequate. In addition, the bill ensures true private market rates are included, provides a much-needed reduction in reporting burden, and protects laboratories and Medicare from dramatic rate increases or decreases with a gradual phase-in approach going forward.”

The CAP has long expressed concern about PAMA’s burdensome reporting requirements and the CMS’ failure to include in payment reporting such a large portion of the laboratory market, resulting in a skewing of the PAMA payment rates. In the last three years, Congress has delayed clinical laboratory reporting periods and delayed cuts to Medicare clinical laboratory fee schedule (CLFS) services to maintain access to laboratory services for patients. However, without a sustainable solution, laboratories face CLFS cuts up to 15% in January of 2023.