Who doesn’t like salsa?? Whoever thought of the short title, and hence acronym, for this bill knew people would be happy seeing it in all caps: SALSA. The Saving Access to Laboratory Services Act (S. 4449/H.R. 8188) is bipartisan and bicameral legislation to amend previous legislation (Protecting Access to Medicare Act [PAMA]) that tied reimbursement rates under Medicare’s Clinical Laboratory Fee Schedule (CLFS) to rates paid by private payors, with clinical laboratories periodically submitting private rate information to the Centers for Medicare & Medicaid Services (CMS). Unfortunately, initial data reporting was a significant under sampling and did not accurately represent the entire laboratory market—the first round of market data was collected from less than one percent of the nation’s laboratories—resulting in drastic, unanticipated cuts to reimbursement.
SALSA was introduced June 22, 2022, to improve the accuracy of market-based Medicare payments for clinical diagnostic laboratory services and reduce administrative burdens in the collection of data by instituting a statistical sampling–based approach to collecting lab test pricing data and increasing the length of time between data collection periods from three years to four years. The new legislation is a little over 1,500 words. In my opinion, language at the section “Least burdensome data collection and reporting processes” could be written more clearly. But as of this writing, nothing has happened with this bill after being sent to Senate and House Committees in June.
In a September 8, 2022, public letter to House and Senate leaders, 26 organizations, including the American Association for Clinical Chemistry, American Clinical Laboratory Association, American Hospital Association, American Medical Technologists, COLA, and CAP (College of American Pathologists) quantified that the under-sampling in PAMA led to nearly $4 billion in cuts to labs providing commonly ordered tests for Medicare beneficiaries. These organizations support the bill and believe it ensures true market rates are included and protects labs and Medicare from dramatic rate increases and decreases through a gradual phase-in approach going forward.
Without Congressional action, beginning on January 1, 2023, laboratories will face additional cuts of as much as 15 percent to frequently ordered laboratory tests. SALSA is a straightforward solution to collecting a statistically representative sample of the entire laboratory market to achieve accurate and sustainable Medicare rates for laboratory services. Hopefully progress is made soon on this legislation.
Something people probably like more than salsa are stories of success, teamwork, and innovation…so please refer to page 55. We are now accepting applications for our 2023 Lab of the Year, which celebrates medical laboratories that demonstrate their extraordinary commitment to quality patient care. Submission requirements are at: https://cdn.mlo-online.com/files/base/ebm/mlo/document/2022/09/LOY2023.6319f98769e44.pdf.
I welcome your comments, questions, and opinions — please send them to me at [email protected].
