American Association for Clinical Chemistry
Better health through laboratory medicine
January 2008 Clinical Laboratory News: Washington Profiles

  
January 2008: Volume 33, Number 12


CMS Moves Forward with Competitive Bidding Demo

On December 5 the CMS conducted a Bidders Conference for laboratories participating in the competitive bidding demonstration project being conducted in the San Diego region. Sixty-six laboratories that provide at least $25,000 in Medicare payment for demonstration tests were invited to participate. Bids are due on February 15 and participating laboratories will be announced in mid-April. Payment under the demonstration will begin July 1. To review the bidders’ package released prior to the meeting, go to the CMS Web site and click on “Demonstration Project on Competitive Bidding of Clinical Laboratory Services.”


New CDC Guidelines on Managing Kids’ Blood Lead Levels

The CDC’s Advisory Committee on Childhood Lead Poisoning has issued its first report on managing childhood lead levels under 10 μg/dL, including ways to reduce children’s lead exposure. The report identifies knowledge gaps and summarizes scientific data relevant to counseling, blood lead screening, and lead exposure risk assessment.

Among recommendations for physicians are: help parents identify and reduce environmental sources of lead, such as paint and contaminated dust and soil; whenever possible, use laboratories that can achieve routine performance of ±2 μg/dL for blood lead analysis; review office procedures to ensure that lead exposure risk assessment or blood lead screening is performed on all children as required by state or local health officials or as recommended by CDC; and perform a diagnostic blood test on all children suspected of having lead exposure or an elevated blood lead level and institute the recommended management guidelines if the lead blood level increases to 10 μg/dL or higher. The recommendations can be viewed in the November 2, 2007 Morbidity and Mortality Weekly Report at the CDC Web site.


     HIPPA Slows Science, Adds Costs

A survey of more than 1,500 epidemiologists nationwide suggests that the Health Insurance Portability and Accountability Act, also known as HIPPA, has hindered and even curtailed some clinical studies before they even begin. More than 66% of survey participants believed HIPPA had made research more difficult to accomplish and almost 40% indicated that the privacy rule had increased research costs.

Enacted in 2003, HIPPA was designed to enhance patient privacy by restricting access to medical records while preserving the legitimate use of such information for social goals. However, institutional review boards may have varied interpretations of the rule, according to researchers at the University of Pittsburgh Graduate School of Public Health. The study was published in the November 14, 2007 issue of the Journal of the American Medical Association (JAMA 2007; 298(18): 2164–2170). Go to the JAMA Web site for more information.


Legislation Introduced to Curb MRSA Spread

On November 15, Congressman Elijah E. Cummings (D-Md.), a senior member of the House Committee on Oversight and Government Reform, introduced the Community and Healthcare-Associated Infections Reduction (CHAIR) Act of 2007, H.R. 4214, legislation to improve the prevention, detection, and treatment of deadly infectious disease. H.R. 4214 specifically addresses the growing concern surrounding the drug-resistant staph infection known as MRSA, or methicillin-resistant Staphylococcus aureus. H.R. 4214 not only addresses the threat of MRSA in hospitals, but also its prevalence in the community, which has become a growing concern. Co-sponsors of the bill are Representatives John Sarbanes (D-Md.), Edolphus Towns (D-N.Y.), and Albert Wynn (D-Md.).

The push to test patients admitted to hospitals for MRSA is growing. Scott & White Hospital (Temple, Texas) has begun a program to test all patients admitted to the hospital to identify if they carry the bacteria. And Washington Governor Christine Gregoire is increasing state efforts to have medical laboratories around the state report cases of MRSA infections.

In addition, the College of American Pathologists (CAP) has developed a proficiency testing product as part of its Surveys program in response to the anticipated need for expanded testing. For more information about the CHAIR Act of 2007, go to the Open Congress Web site. To learn more about the CAP Surveys program, go to www.cap.org.


CMS Begins Third Annual Medicare Provider Satisfaction Survey

CMS has begun its third annual provider satisfaction survey of Medicare fee-for-service contractors who process and pay more than $280 billion in Medicare claims each year. The survey is designed to gather quantifiable data on provider satisfaction levels with the key services of the provider-contractor relationship. Focal points of the survey include: provider inquiries, provider outreach and education, claims processing, appeals, provider enrollment, medical review, and provider audit and reimbursement.

CMS is sending the 2008 Medicare Contractor Provider Satisfaction Survey (MCPSS) to about 35,000 randomly selected providers, including physicians and other healthcare practitioners, suppliers, and institutional facilities that serve Medicare beneficiaries nationwide. CMS plans to make the survey results public in July 2008. Additional information about the MCPSS can be found at the CMS Web site.


CMS Proposes New Value-Based Hospital Payment System

In a report to Congress, CMS is recommending that the current hospital pay-for-reporting mechanism be replaced with a pay-for-performance initiative as part of its value-based purchasing program. Accordingly, a percentage of the hospital’s DRG payments would be contingent on the hospital’s actual performance on a specific set of measures. Failure to meet the requirements would result in reduced payments. The agency proposes to transition from a pay-for-reporting to an incentive-based system over a three-year period.  The report can be seen on the CMS Web site.


Newborn Screening Bill Advances in the Senate

On November 14, 2007, the Senate Health, Education, Labor and Pension (HELP) Committee passed AACC-supported legislation, S.1858, the “Newborn Screening Saves Lives Act of 2007.” If enacted, it would “expand state newborn screening programs to cover the recommended 29 specific tests, and improve the laboratory quality and surveillance for newborn screening.” Although the legislation has been reported to the full Senate, a vote on the matter has not yet been scheduled. Similar legislation, H.R.1634, has been introduced in the House.

For additional information about these bills, visit the congressional Web site.