Everybody Loves SALSA: Support the Saving Access to Laboratory Services Act

“We've all had enough politics right now, but we have a small opportunity to have a potentially large impact on the financial environment for clinical laboratories in the United States. It will take swift, strong, and forceful action on the part of the clinical laboratory community.” —American Society for Clinical Laboratory Sciences, November 2022.

What is the Support the Saving Access to Laboratory Services Act?

The Saving Access to Laboratory Services Act (S.4449/H.R. 8188), or SALSA, is a bill introduced by Senator Richard Burr (R-NC) on June 22, 2022, to update data reporting requirements and payment methodology enacted under the 2014 Protecting Access to Medicare Act (PAMA). The data collection under PAMA was meant to reform the Clinical Laboratory Fee Schedule (CLFS) to a single national fee schedule based on private market data from the nation’s medical laboratories. However, this data sampling only came from 1,942 labs out of more than 250,000, including only 21 hospitals nationwide, leaving an enormous misinterpretation of the fee system.

Congress has intervened on a bipartisan basis three times to delay Clinical Lab Fee Schedule reporting periods and twice to delay cuts during the COVID-19 public health emergency. If Congress fails to act again before January 1, 2023, clinical labs will see almost immediate reductions of 15 percent in the Centers for Medicare & Medicaid Services (CMS) reimbursement, sending a devastating ripple across our nation’s critical health infrastructure and the Laboratory Response Network.

SALSA is a permanent solution with bipartisan, bicameral support. It’s also supported by more than 60 organizations representing the interests of patients, providers, hospitals, and clinical labs. The bill would establish a new authority within the Centers for Medicare & Medicaid Services to collect private market data through statistically valid sampling from all types of clinical laboratories. The bill ensures that the market rates are accurate, provides a reduction in the reporting burden, and protects labs and Medicare from dramatic decreases in reimbursement with a gradual, phased approach.

In short, SALSA will require broader data collection across the clinical laboratory market and place limits on annual payment reductions to prevent instability of the CLFS. Enacting the bill  before year’s end is critical—the bill will ensure patient access to quality testing by qualified, board-certified professionals, allow for innovation, and build on the infrastructure necessary to protect access to public health.

How can you support the Saving Access to Laboratory Services Act?

During the 2022 Laboratory Legislative Symposium in September, ASCLS, ASCP, AMT, PAMET-USA, and other laboratory organizations and advocates were able to secure many co-sponsors for the bill, but we need more help to reach Congress during the current lame duck session before the House turns over to Republicans at the end of the current term. 

The American Clinical Laboratory Association (ACLA) has provided a number of resources. Now it's your turn to take action and contribute to the effort:

Visit StopLabCuts.org and contact your representative and two senators. If you aren't sure who they are, the system will automatically choose them for you under the "Take Action" tab. Follow up with a phone call to both your representative and two senators and ask them to communicate to their caucus leadership that they are supporting passage of SALSA.

For a detailed summary on the background of The Protecting Access to Medicare Act (PAMA) and The Saving Access to Laboratory Services Act (SALSA), read Clinical Laboratory Reimbursement in the United States from ASCLS.