The National Independent Laboratory Association (NILA) has issued a news release expressing “deep concern” about recommendations for cuts in Medicare lab payments recently proposed by the federal Office of Inspector General (OIG), part of the Department of Health and Human Services. Mark Birenbaum, PhD, NILA’s administrator, comments, “There are clear oversights and omissions in the approach taken by the OIG to examine the laboratory market.” The NILA release makes several specific points: that the OIG report compared the Medicare payments of only 20 laboratory tests, out of more than 1,000 in the overall testing market; that rates were compared with Medicaid at a time when, due to strained state Medicaid budgets, reimbursement for healthcare services in general are very low; and that the report includes only data from independent and physician office-based labs, ignoring hospital laboratories.
Noting that clinical laboratories have received significant cuts in reimbursement since 2011, including a cut related to sequestration, Birenbaum says, “This is death by a thousand cuts for the nation’s community laboratories.” Instead of “blind direct fee cuts and copays,” he says, “NILA wants to work in partnership with policymakers to modernize the laboratory fee schedule to ensure that tests are appropriately valued.” See what you think of the OIC document: “Comparing Lab Test Payment Rates: Medicare Could Achieve Substantial Savings.”
