Although Congress continues its attempts to resolve the many provisions of the Prescription Drug and Medicare Improvement Act of 2003 (S.1), the copayment provision for clinical laboratory services in the Senate version of the Medicare prescription drug bill remained, until late last month, an immediate and viable threat to the survival of our nations laboratories.
The copay provision would have imposed a tremendous financial and administrative burden on top of 17 years worth of systematic cuts to Medicare payments for laboratory services. If passed, the copayment would have required labs to find more than $18 billion in revenue over the next decade and every Medicare beneficiary to pay 20% of the cost of every lab test they receive.
CLMA directed an intense grassroots effort to combat this provision and its members responded to repeated calls to action by contacting their legislators, visiting them in their home states and distributing patient flyers.
Late-breaking news
We are thrilled to say our collective efforts have affected important change to this legislation the damaging copay provision has been removed from consideration. Our efforts are getting through, but the fight is not over. At press time, the House and Senate Medicare conferees are in the last days of negotiating a final version of the bill.
The Clinical Laboratory Coalition, of which CLMA is an active participant, has learned that a cut in Medicare reimbursement for laboratory services may be combined with a five- to seven-year freeze on the Consumer Price Index update. Reports indicate that this cut/freeze combination may be a last attempt to obtain savings in an amount comparable to that of the copay provision ($18.6 billion).
The Medicare bill was still on track for a floor vote prior to a Thanksgiving adjournment by Congress, so time was running out.
This is a fluid situation. The latest information can be accessed by logging in to the Members Only section of www.clma.org and visiting the Policy section. Please follow up with Kathy Ayres, CLMA director of Health Care Policy, at [email protected] to report on your contacts.
Congress truly has heard CLMA and its members, and great strides have been made in raising awareness on Capitol Hill about the importance of this issue. It is, however, just as important for all laboratory professionals to make their voices heard. Our industry is at a critical juncture, and our united and continued efforts over the coming weeks will be essential to defeating this potential cut and freeze to laboratory reimbursement.
Katharine Ayres, MT(ASCP), CT, is CLMAs director of healthcare policy and is responsible for the associations legislative and regulatory activities, as well as for writing the CLMA Email Alerts. She is a second-generation laboratory professional with 20 years bench and supervisory experience in Philadelphia area hospitals and health systems.
10 easy steps on how to make waves with Congress
- Dial (202) 224-3121 and ask for your legislative representative, or locate direct numbers for Representatives via www.house.gov or for Senators via www.senate.gov.
- Speak to your Congressman or his healthcare-issues staff members about important points that concern you, personalizing the issue to your facility, and ask that a specific action be taken.
- Leave voicemail (if no one is available) with your name, facility name, phone number and concern.
- Send your contact a follow-up thank-you (see addresses info below), re-emphasizing pertinent points and reiterating your request for action.
- Campaign by letter, first viewing samples at the Members Only section at www.clma.org and click on the Policy section. Draft your own letter to send via mail or e-mail, detailing your concern.
- Connect with your Senator by visiting www.senate.gov, clicking on List Senators by State, finding your state, then simply sending an e-mail.
- Contact your Representative by visiting www.house.gov, scroll down to Write Your Representative, follow the easy directions, then send your e-mail.
- Personalize your hard-copy letter, using The Honorable (name), United States Senate, Washington, DC 20510, or The Honorable (name), United States House of Representatives, Washington, DC 20515.
- Remember in your correspondence to include your facilitys name and details about what you do.
- Dont give up!
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2003 Nelson Publishing, Inc. All rights reserved.
