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AACC Memo on State e-GFR Legislation





DATE:           MARCH 14, 2006



                    SHARON EHRMEYER, PhD, CHAIR, GRC


TO:              SECTION CHAIRS



                    E-GFR CALCULATIONS



Over the past two years, model legislation has been introduced in a number of states that would require clinical laboratories to calculate and report a patient’s estimated  glomerular filtration rate (e-GFR) when a serum creatinine test is ordered—even if the physician does not request it.  To date, four states have enacted such legislation, although none this year.  Recently this issue has gotten more attention.  Given the large number of states considering this legislation, and the laboratory focus of the measure, it’s likely you may be asked the Association’s position on this issue.   Thus, the purpose of this memo is to provide you with that information. 


AACC is opposed to this legislation.  In general, the Association does not believe it is good public policy to require by statute the use of a particular method or calculation or test.  The decision on what procedure to order should be made by the physician, in consultation with the clinical laboratory.  AACC believes the best approach to improving patient care is through education, not through legislative fiat.  The Association is concerned that statutory mandates may ultimately stifle the development and dissemination of new technologies, while unnecessarily creating dissension within the health care community.


It is important to separate the politics from the science.  Although AACC opposes the legislation, it does not oppose the NKDEP initiative to promote the use of the e-GFR.  AACC encourages its members to learn about the calculation, read the scientific literature, consult with their physicians and consider implementing it within their own institutions.  We encourage you to review the valuable information on the NKDEP website, www.nkdep.nih.gov, and please take note of the additional information for laboratory professionals at www.nkdep.nih.gov/labprofessionals/index.htm.


Please watch for a front page article on the e-GFR in the April Clinical Laboratory News and note that AACC will run a free Expert Access online program at the beginning of May at www.aacc.org.  We hope you will take the time to learn more about this potential improvement in patient care.


If you have any questions or concerns regarding the state legislation, please contact Vince Stine, PhD, Director, Government Affairs, at (202) 835-8721 or vstine@aacc.org.  For more information about GFR, please contact Greg Miller, PhD, Professor of Pathology, Medical College of Virginia, who was the Chair of the NKDEP working group that developed the calculation, at (804) 828-0375 or gmiller@vcu.edu. Hopefully, this document will help you and your section more readily deal with this issue if it emerges as an issue in your area—if it hasn’t already.  Thanks.

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