Bill to Update Medicare Payment Schedule
Congress is considering legislation that will update the rules governing Medicare to incorporate changes in diagnostic practices afforded by technology innovations such as molecular diagnostic testing. The legislation is driven, in part, by the critical role that lab tests play in healthcare decision making.
The Advanced Laboratory Diagnostics Act (ALDA) of 2007 (H.R. 1321), bipartisan legislation introduced last week by Rep. Mike Ferguson (R-NJ) will update Medicare to incorporate new laboratory tests used for diagnostic purposes. More specifically, the bill will modify payment guidelines under the Social Security Act to update the fee schedule for clinical laboratory tests.
The focus is new advances in diagnostic testing which are not currently paid covered by Medicare. Early detection often results in decreased overall costs to treat diseases more amenable to treatment if diagnosed early. The legislation supports evaluation to assess the updated payment schedule proposed, as well as correction of previously determined reimbursement rates. The American Society for Clinical Laboratory Science, the Association of Medical Technologists, and the Clinical Laboratory Management Associationhave all endorsed the legislation.
A study from the Institute of Medicine published in 2000 noted inadequacies in the Medicare fee schedule.
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March 19, 2007 Related topics: Legal & legislative