ASCP worked feverishly in 2009 to ensure that pathology’s voice in health care reform proposals on Capitol Hill was heard.

Overall ASCP has been supportive of health care reform efforts on Capitol Hill but did not endorse the overall packages that were moving through the House and the Senate. As a patient-centric organization ASCP believes it is important that pathology and laboratory services are available to all of our nation’s patients. The Society adopted health care reform as one of its top public policy priorities in 2008 and in 2009. Throughout 2008-2009 ASCP and its members’ advocated policies that would provide the nation’s patients with access to high quality pathology and laboratory services.

Pathology is a service not a commodity and ASCP advocated to include provisions in both the House and the Senate legislation that would close the loopholes on physician self referral that have been created by the In-Office Ancillary Service Exception (IOAS) under the Stark law. Unfortunately, the efforts to close the Stark IOAS exceptions were not included in health care reform legislation but our efforts on this issue will continue.

ASCP also worked with the medical community to pass a fix to the Sustainable Growth Rate (SGR) Formula under Medicare. ASCP did endorse H.R. 3961, the “Medicare Physician Payment Reform Act,” which will replace the physician payment system that is widely acknowledged to be dysfunctional and that continually threatens access to care for our nation’s elderly and disabled patients. A fix to the SGR would also provide physician practices with financial stability and predictability and enable them to invest in the infrastructure needed to build a health care system for the 21st century. Without Medicare physician payment reform, the goals of health system reform will remain out of reach.

In September, ASCP and the pathology community successfully removed a Senate Finance Committee provision that would have implemented a 20 percent co-pay on Medicare-covered lab tests and a tax on all clinical laboratory and pathology revenue. Over 2500 letters were sent through the ASCP e-Advocacy Center in a 48 hour period to defeat the proposed co-pay.

However, as of early November 2009, both House and Senate reform bills included proposals to reduce the annual adjustment to the clinical laboratory fee schedule (CLFS) by an amount equivalent to the estimated annual increase in productivity, as determined by the U.S. Dept. of Labor. Historically, such estimates have averaged about 1.4 percent. In addition, the Senate version imposes a 1.75 percent reduction in the CLFS, also effective in 2011. This reduction would increase to 1.95 in 2015 to pay for a partial, temporary change to the current prohibition on direct reimbursement of tests ordered within 14 days of a patient discharge from a hospital. The bill also extends the provision allowing for technical component billing by independent laboratories performing services for Medicare inpatients and “reasonable reimbursement” for laboratory services provided at small rural hospitals. There is also a provision calling on the Centers for Medicare and Medicaid Services to submit a report to Congress outlining recommendations for legislative and administrative actions to reform the reimbursement mechanisms for new clinical laboratory tests.  

ASCP Health Care Reform Resources:
Baucus Letter (June 9, 2009)
ASCP's  Self Referral Policy Statement
2009 ASCP Public Policy Priorities
Action Alert:  Tell the Senate: Lab Tests Don't Belong in Health Care Reform (Aug. 2009)