New York Labs Fight Medicare 20% Co-Pay

Medicare patients respond to educational inserts sent with lab bills and call their Congressman

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CEO SUMMARY: Participating laboratories in the New York State Clinical Laboratory Association (NYSCLA) generated a flood of calls to their state’s congressional delegation in recent weeks. Included in their bill for lab testing, patients got a flyer telling them about pending legislation that would impose a 20% Medicare lab test co-pay and asking that they call their congressional representative to voice opposition.

ONCE AGAIN, independent laboratories in New York State proved they can educate patients about legislation and motivate a substantial number of patients to call their elected representatives.

In recent weeks, independent laboratories in New York State mobilized to respond to the Senate’s proposal, passed during the week ending June 27, to require Medicare patients to pay a 20% co-payment for Part B laboratory testing services.

During the time the bill authorizing this provision was debated in the House and Senate, independent laboratories in New York mounted a patient education campaign that triggered a sustained barrage of phone calls to the offices of the state’s senators and representatives. At least one senator’s office called a New York laboratory and asked that the informational campaign cease, because the wave of telephone calls had overwhelmed the senator’s phone system.

“In New York, we know how to fight this battle,” said Tom Rafalsky, President of the New York State Clinical Laboratory Association (NYSCLA). “We borrowed a page from the playbook we used a couple of years ago. When state legislators surprised us with a tax surcharge on laboratory tests in 1997, several of our member laboratories began enclosing informational flyers about the tax with the bills they sent to patients. The flyers encouraged patients to call their representative or the governor’s office and express their opinion about the lab test tax surcharge.

Overloaded Phone Systems

“Legislators overlooked the fact that labs in New York send out more than 100,000 patient bills per week,” noted Rafalsky. “The number of phone calls generated by this campaign literally swamped the governor’s office, the New York Department of Health, and the offices of state senators and representatives. We got their full attention and the lab test tax surcharge was eventually repealed.” (See TDR, February 17, 1997 and April 26, 1999.)

According to Rafalsky, independent laboratories such as Enzo Clinical Labs, Quentin Medical Labs, Sunrise Medical Laboratory, and Universal Medical Laboratories were among the lab companies which included flyers about the Medicare lab test co-pay legislation with bills sent out in recent weeks. Even on short notice, the educational effort had an impact, at least in some offices of the New York congressional delegation.

Calls To Hillary Clinton

“We know that Senator Hillary Clinton’s office was inundated with phone calls from seniors who wanted to object to the 20% lab test co-pay provision,” declared Larry Siedlick, CEO of Sunrise Medical Laboratory in Hauppage, New York. “That’s because her office called me directly. I was told that the senator’s switchboard had been overloaded with constituent calls on the 20% co-pay issue for more than a week. It was specifically requested that we stop sending these informational flyers to patients!

“The positive outcome was that I was given the opportunity to brief one of Senator Clinton’s legislative aides about the co-pay situation,” he continued. “Senator Clinton and her staff are now aware of the issue and the problems it will cause for both senior citizens and clinical laboratories. During the call I was reminded that this is a Republican measure and the Republicans control the Senate, so Senator Clinton’s ability to oppose or alter this legislation is limited.”

Untapped Lab Power

The efforts by independent clinical laboratories in New York demonstrate that the laboratory industry has great power to educate and influence—particularly if it will go directly to the public with its message. Repeatedly in past years, THE DARK REPORT has observed the the lobbying strategies and efforts of the lab
testing industry have been of limited effectiveness since the late 1980s.

During the past 15 years, reductions in laboratory test reimbursement, medical necessity coding requirements, failure to get regular yearly cost-of-living updates (authorized for literally all other healthcare services), and now the possible reimposition of the 20% patient co-pay provide ample examples of how ineffective the lab industry’s lobbying infrastructure has been. THE DARK REPORT advocates that, if what has been done in recent years isn’t working—then it’s time to try other lobbying approaches with Congress.

That’s why labs in other parts of the nation should emulate the technique used by labs in New York State: educate constituents by using informational flyers stuffed in patients’ lab test bills. In the battle to repeal New York State’s onerous 8.18% state lab tax surcharge, the court case filed by the lab industry went nowhere. It was not until patients, alerted by the flyers, began calling legislators that decisive action was taken and the lab tax surcharge was eventually repealed.

Time For Action

For laboratories across the United States, now is the time to act to oppose congressional efforts to require patients to pay the 20% co-payment on Part B Medicare laboratory tests. Were labs in communities around the country to begin sending similar informational flyers to patients in their lab test bills, elected officials in Congress on both sides of the aisle would get a message that would be tough to ignore.

As demonstrated in New York State, the “flyer in the bill” strategy can be the lab industry’s lobbying “ace in the hole!”

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