Time to Change Bad Medicare Lab Policies

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BYZANTINE MEDICARE REGULATIONS AND BELTWAY POLITICS are uncommon topics for THE DARK REPORT. There are any number of other sources out there that provide ample details about laboratory compliance, the complexities of billing and coding, and whether Senator Smootly will or won’t vote for reinstating the 20% lab co-pay.

However, I believe the subject of long-overdue reforms to Medicare laboratory payment policies should be a top priority for every laboratory administrator and pathologist in the United States. You don’t need me to remind you that, for virtually every year since 1987, Medicare funds have been taken off the lab industry table. That’s right! Fourteen consecutive years of funding haircuts that no other class of healthcare provider has been asked to endure.

There is only one reason this situation occurred: the clinical laboratory industry has never spoken to Congress, the President, and HCFA with one united and persistent voice. We all know the reasons why. Over the years, commercial labs had one agenda, pathologists had another, and hospital labs primarily get paid under Part A, so they really didn’t care what happened to Part B lab payment policies.

It’s time to change that situation. As you will read in this issue, the Institute of Medicine recently studied Medicare laboratory payment policies and issued 12 recommendations for reform. This is a significant development and gives the clinical lab industry an unprecedented opportunity for change. At the upcoming Executive War College in Cincinnati, IOM committee member John Matsen, M.D. will speak to the Lab CEO SUMMIT about how the IOM committee developed these recommendations, and his view on how the lab industry can work with the government to turn these recommendations into tangible reforms that benefit the entire lab testing community.

Attending the Lab CEO SUMMIT on May 10 will be a number of leaders from large lab organizations and several lab professional associations. Editor Michel hopes this group can bridge traditional differences and lay the groundwork for a truly broad coalition of lab industry interests that are willing to work together to insure speedy and vigorous enactment of the IOM’s recommendations. I would encourage any of you interested in supporting this effort to contact us at THE DARK REPORT so you can be briefed and included in future activities.


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