“Here’s to Plain Talk and Clear Understanding!”

“WELL, SIR, HERE’S TO PLAIN TALK AND CLEAR UNDERSTANDING.” That’s a well-known line in the classic 1941 detective movie, “The Maltese Falcon.” It’s spoken by the Kasper Gutman character, played by Sidney Greenstreet, to San Francisco private eye, Sam Spade, played by Humphrey Bogart. Gutman thinks Spade has the priceless Maltese Falcon statue and he wants to get to the answers quickly.

I’ve been reminded of that line during the past seven months, every time the Centers for Medicare & Medicaid Services (CMS) has stepped into the public arena and discussed the impending Medicare Clinical Laboratory Competitive Bidding Demonstration Project or released documents about the pilot demonstration it plans to conduct in the San Diego-Carlsbad-San Marcos MSA (metropolitan statistical area). Officials from CMS have absolutely failed to meet the standards outlined by Kasper Gutman, when he asked for “plain talk and clear understanding.”

To the contrary, officials from CMS and its minions at RTI International, Inc. (the contractor which has done development work for the past 12 years on the laboratory competitive bidding project) have done the opposite of “plain talk and clear understanding.” They refuse to speak in a clear, understandable manner. They decline to offer objective, frank, and easy-to-understand insights about the requirements of the laboratory competitive bidding demonstration project. What makes this doubly insulting to the laboratory profession is that these same officials are public servants, chartered by the Constitution and various statutes to serve in the interest of the American public, with due process, and respect for the concepts of fair play that make this Republic an example of freedom and the rule of law.

Against the morass of obfuscation, complexity, and deliberate negative bias that marks the way CMS is proceeding with the lab competitive bidding demonstration, I think it is refreshing how at least one leader in the lab industry is willing to boldly use “plain talk and clear understanding” to state the obvious. As you will read on the following pages, Alan Mertz, President of the American Clinical Laboratory Association (ACLA) in Washington, DC, declared that the laboratory competitive bidding demonstration is “coerced bidding to force labs to bid below the true cost of providing the service… and that’s not a bid demonstration which is objective and competitive.” Kudos to Mr. Mertz. Let’s hear more plain talk and clear understanding from our lab industry leaders!


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