In This Issue...

Senate Committee Passes AACC-Backed Newborn Screening Bill

On December 18th the Senate Health, Education, Labor and Pensions Committee approved S.1418, the Newborn Screening Saves Lives Act, which reauthorizes federal assistance to state newborn screening programs.  The legislation, sponsored by Senators Kay Hagan (D-NC) and Orrin Hatch (R-UT), 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.

The measure also seeks to reduce the time it takes to conduct newborn screening tests as well as the review process for approving new measures.  According to Senator Hagan, “the system is only effective if samples are taken and screened in a timely manner.  This bill increases federal support to make sure that newborn screening happens promptly.”   More specifically, Senator Hagan’s refinements to the existing program would:

  • Allow states to use grants from the Health Resources and Services Administration to improve the timeliness of newborn screening systems;
  • Require that demonstration grants evaluate the timeliness of newborn screening;
  • Direct the Advisory Committee on Heritable Disorders in Newborns and Children to provide recommendations for the rapid diagnosis and follow up with newborns; and
  • Include timeliness as one of the objectives of the Centers for Disease Control and Prevention’s laboratory quality and surveillance activities. 

AACC is working with congressional offices and other health care groups to enact newborn screening legislation. The Association urges you to go to our website and send an e-mail to your legislative representatives asking them to cosponsor the bill.  Now that the HELP committee has passed the bill, the measure moves to the full Senate for a vote.

Lab Fees Cut by 2.75 percent for 2014

Medicare reimbursement for clinical laboratory testing will be cut by 2.75 percent in 2014.  The consumer price index (CPI) update for clinical laboratories this year is -0.75 percent as a result of payment adjustments required by the 2010 Affordable Care Act.  This reduction, combined with the two percent cut in Medicare provider payments resulting from sequestration, account for the lower payments. Information about the payment reduction is on the CMS website

CMS Excludes Labs from EHR Self-Referral Rule

On December 27, 2013, the Centers for Medicare and Medicaid Services (CMS) published a final rule extending the self-referral exceptions that allowed certain providers to ‘donate’ electronic health record (EHR) technology to physicians.  According to CMS, the purpose of the exceptions was to increase the use of EHRs in medical practices.

Initially, clinical laboratories were included as one of the providers allowed to ‘donate’ EHR’ technology.  However, both clinical laboratories and physicians alleged that fraudulent practices were occurring. Clinical laboratories suggested that physicians were demanding EHR ‘donations’ as a condition for getting their testing; whereas physicians claimed that laboratories were requiring them to meet certain test volume levels to receive the equipment. 

In the end, CMS agreed to eliminate clinical laboratories from the self-referral exception, thus barring labs from donating such equipment or related services to physicians. The final rule takes effect on March 27, 2014. 

New Study Indicates HCR May Increase Medicaid ER Visits

A Harvard University Study published in Science reports that greater access to health care services through Medicaid may increase, rather than reduce, the number of visits by low-income individuals to the emergency room (ER).  The study examined the Oregon state expansion of Medicaid that started in 2008.  The findings indicate a 40 percent increase in ER visits by the newly insured compared to the uninsured.  This goes counter to many of the arguments made during health care reform that greater access to primary care physicians would reduce ER visits.  For hospitals, this could mean an increase in laboratory testing, but at the lower Medicaid fees.  For more on this story, please visit MIT News.