In This Issue...

CMS Releases Draft Molecular Payment Rates

On May 9th, the Centers for Medicare and Medicaid Services (CMS) released its proposed payment rates for the new molecular codes.  The agency used the gap-fill process to develop these rates.  The agency is accepting comments through July 8th.  CMS will publish the final payment rates in September, which will be in effect for 2013 and 2014.  A reconsideration process will take place in 2014 to address any payment discrepancies. Please send a copy of your comments to

Rep. Roybal-Allard Introduces Newborn Screening Measure

Rep. Lucille Roybal-Allard (D-CA) and Rep. Michael Simpson (R-ID) introduced H.R.1281, the Newborn Screening Saves Lives Reauthorization Act, which would preserve recent advances in state newborn screening programs. Since the enactment of earlier legislation, the number of states testing for 29 of the 31 treatable core conditions has increased four-fold. 

In addition to expanding access to newborn screening, H.R.1281 would: 

  • help state screening programs better assess and coordinate newborn treatments;
  • continue research towards identifying treatments for conditions that can be detected through early testing;
  • ensure the quality of testing provided by newborn screening laboratories; and
  • renew the Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children.

AACC recently endorsed H.R.1281. A copy of the legislation is available on the congressional web site, THOMAS.

GOP Leaders Refuse to Nominate IPAB Reps

Republican House and Senate leaders are refusing to nominate individuals to serve on the Independent Payment Advisory Board (IPAB) mandated by the 2010 health care reform law.  In a May 9th letter to the President, Senate Minority Leader Mitch McConnell (R-KY) and House Speaker John Boehner (R-OH) stated that the IPAB would give “15 unelected, unaccountable individuals the ability to deny seniors access to innovative care” and that additional payment cuts would “force providers to stop seeing Medicare patients.”  The GOP leaders further objected to decisions being made in the “absence of the democratic process, without the system of checks and balances that would normally apply to important matters of public policy.”  Without Republican support, the President will be unable to implement this provision, since IPAB members require congressional confirmation.  AACC has joined with other groups in supporting legislation to repeal IPAB.

USPSTF Recommends HIV Screening for Adolescents and Adults

The United States Preventive Services Task Force (USPSTF) is recommending that all adolescents and adults aged 15 to 65 get screened for HIV.  The advisory panel assigned an ‘A’ level designation to its recommendation – the highest under its evaluation system.  According to USPSTF, roughly one-quarter of the 1.2 million individuals with HIV in the United States are unaware of their status.  The group further found “convincing evidence that conventional and rapid HIV antibody tests are highly accurate in diagnosing HIV infection” and that early detection and treatment can reduce the rate of transmission and mortality.  The USPSTF concluded “with high certainty that the net benefit of screening for HIV infection in adolescents, adults, and pregnant women is substantial.”

CMS Releases Hospital Price Data

The Centers for Medicare and Medicaid Services (CMS) released Medicare charge data from more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments.  The data set includes the prices billed by hospitals for the 100 most common inpatient procedures.  News publications highlighted the amounts billed by different institutions for the same procedure.  For example, the Washington Post pointed out that one medical center in Dallas billed Medicare $160,832 for lower joint replacements, whereas a facility five miles away billed an average fee of $42,632.  According to HHS, “businesses and consumers alike can use these data to drive decision-making and reward cost-effective provision of care.”  CMS hopes greater price transparency will led to improvements in the delivery of health care.

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Enroll today in AACC’s certificate program for Regulatory Affairs for Laboratory Compliance.  This program will provide you with a broad understanding of the laws and regulations that govern your laboratory and provide vital insights into how to comply with them.  In addition to online lectures, you will have the opportunity to test your knowledge through self-assessments and earn continuing education credits.  Go to the regulatory affairs certificate web page to get more information on this AACC program.