NILA’s Key Informant Report About Impact of PAMA Cited in Forbes Op-Ed
NILA's efforts to amend the Protecting Access to Medicare Act (PAMA) are highlighted in an Op-Ed by the Galen Institute published in the July 27, 2018, Forbes Online.
The Galen Institute, a not-for-profit health and tax policy research organization, recently released a study, “Can Medicare Pay Market Rates? A Study of the Clinical Laboratory Fee Schedule Methodology,” that explores the flawed methodology CMS used to gather data to tie the Clinical Laboratory Fee Schedule (CLFS) to market-based rates.
The Galen Institute's study, and its Forbes Op-Ed, both cite the Key Informant Interview Report NILA conducted earlier this year that explored the impact of PAMA on community laboratories. NILA reported that the PAMA-induced cuts to Medicare's CLFS are pressuring NILA's member laboratories to limit services and reduce workforces, which in turn is creating beneficiary access issues, especially in small and rural communities.
The Galen Institute states that CMS "produced a reimbursement system that does not reflect payments for lab tests in the private marketplace and that does not abide by statutory intent," and concludes that "Both Congress and CMS need to reassess the fledgling CMS plan in order to rationalize (laboratory) payments and not lock in a policy that could well put access to necessary diagnostics in jeopardy for millions of seniors."