Congress delays PAMA cuts

Dec. 13, 2021

The U.S. Senate and House passed legislation that delays for one year pending cuts to the Clinical Laboratory Fee Schedule (CLFS) and the next reporting period for submitting private payer data, according to multiple healthcare advocacy organizations. They expect President Biden to sign the bill soon.

Both the cuts and reporting requirements were scheduled to go into effect on January 1, 2022.

The bill follows action Congress took last year to delay implementation of CLFS cuts as part of the Coronavirus Aid, Relief, and Economic Security Act, according to the American Hospital Association (AHA) and the National Independent Laboratory Association (NILA). The cuts and reporting requirements were originally enacted as part of the Protecting Access to Medicare Act (PAMA).

But without the action taken last week, laboratories would have seen “cuts as large as 15% to some of the most common tests on their menus,” the AHA said. The bill also delayed until January 1, 2023, the requirements that laboratories report data on clinical laboratory test codes, payments, and volume data from private payers, the AHA said.

The bill also delays other scheduled payment cuts in the healthcare industry. For example, the AHA said, "the bill would extend the moratorium on the 2% Medicare sequester cuts until April 1, 2022, and then reduce the cuts from 2% to 1% from April 1 through June 30, 2022. The package also would stop the 4% statutory Pay-As-You-Go sequester from taking effect early next year."

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