PAMA Cuts Averted Again for Clinical Lab Services
ACLA applauds congressional action to delay Medicare decreases and urges long-term reform
Scott Wallask, BA, is senior editorial manager for Today’s Clinical Lab and G2 Intelligence. He has spent more than 25 years covering the healthcare and high-tech industries. A former newspaper reporter, he graduated from Northeastern University with a degree in journalism.
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In good news for clinical laboratories, Congress passed a short-term spending bill that included a reprieve of upcoming decreases in Medicare reimbursement for hundreds of diagnostic services.
The Protecting Access to Medicare Act (PAMA) of 2014 called for the decreases. PAMA cuts of 15 percent would have taken effect on January 1, 2025, without the congressional vote on September 25.
Congress has similarly delayed PAMA cuts for the past five years, largely due to the pandemic and subsequent lobbying by the lab industry.
However, labs will find themselves in the position next year of again facing cuts on January 1, 2026, unless Congress steps in. This recurring situation has led the clinical lab industry to advocate for longer-term PAMA relief.
ACLA president: ‘Long-term reform is urgently needed’
The American Clinical Laboratory Association (ACLA) commended Congress for its vote, saying up to 800 lab services would have been affected by the 15 percent decrease in reimbursement.
“We are pleased that Congress has delayed pending reductions, recognizing the harm repeated Medicare reductions would have on the nation’s health care system that relies on clinical laboratory testing every day to inform patient care,” said ACLA President Susan Van Meter in a statement. “This is a welcome step to ensuring patients can continue to rely on timely and accurate diagnostic services.”
“There is widespread and bipartisan recognition that long-term reform is urgently needed,” added Van Meter. “A sustainable reform of the Medicare payment system for clinical laboratory services is vital to protect and enhance patient care, foster innovation, and ensure the stability of clinical laboratories nationwide.”
The upcoming US presidential election will likely have some downstream effect on clinical laboratory operations. Beyond whether PAMA reform is achievable with a new president, a source noted that lab lobbyists have likely spoken to each presidential campaign to gauge whether new regulation of laboratory-developed tests might be softened.