Congress Votes: No PAMA Price Cuts for 2022

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IT’S WELCOME NEWS THAT CONGRESS VOTED EARLIER THIS MONTH to defer the PAMA price cuts to the Clinical Laboratory Fee Schedule (CLFS) that were scheduled to take place in 2022. This is a positive development for the finances of the nation’s clinical labs, particularly the smaller, independent labs that are often the only local labs for the communities they serve. (See this article.) 

Yet, given the reticence of members of Congress to address the fundamental flaws and biases in how officials at the Centers for Medicare and Medicaid Services are implementing the Protecting Access to Medicare Act of 2014 (PAMA) in recent years, why did Congress act now? The pandemic is the main factor. Since the outbreak started in the winter of 2020, the federal government has now twice postponed implementing the next round of PAMA price cuts, which cannot exceed a 15% reduction for any specific test. The first postponement delayed the Jan. 1, 2021, implementation. This new legislation now postpones these lab test price cuts until Jan. 1, 2023. 

Deferring this next round of PAMA price cuts to the CLFS is the least the lawmakers in Congress can do for the nation’s clinical labs. Since the outbreak of the COVID-19 pandemic, the nation’s clinical laboratories and anatomic pathology groups did yoeman’s work to speedily ramp up SARS-CoV-2 testing to handle more than two million COVID-19 tests per day at peak demand, while at the same time collaborating with government health officials to set up and staff drive-through specimen collection sites throughout the United States. Lab administrators, pathologists, and staff worked 7-day/15-hour work weeks from the onset of the pandemic in early 2020 through the winter of 2021. It was a superhuman effort by lab professionals that benefited the American public. 

Those walking the halls of Congress and speaking to elected officials and their staffs tell our editorial team that there is now great recognition about the vital role that medical laboratory testing plays in keeping the population healthy and fighting infectious disease outbreaks like SARS-CoV-2. It seems timely for the entire laboratory profession to come together, strike while the proverbial iron is hot, and educate Congress about the need to reform the existing PAMA statute as written and permanently fix the flaws that financially starved numerous community labs, causing their closure or sale, thus depriving Medicare beneficiaries of local access to quality lab testing services. 

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