In This Issue...

Congress Cuts Lab Payments

On February 17, 2012, the House of Representatives and Senate passed H.R.3630, the “Middle Class Tax Relief and Job Creation Act of 2012,” to extend the Social Security payroll tax cut, to increase the number of weeks of unemployment payments, and to postpone a 27 percent cut in physician payments. Included in this legislation were a number of budget cuts to pay for the extended benefits, including one affecting clinical laboratories.

Starting in 2013, the laboratory fee schedule will be reduced by two percent. According to the Congressional Budget Office, this change will cut laboratory payments by $2.7 billion through 2022. The measure stipulates that this reduction will be applied after the 2013 update is calculated, thus becoming the “new reset base.”

Unfortunately, the laboratory community could also face additional cuts in 2013. The failure of Congress to reach agreement on a debt reduction plan last year means that the Administration is required to implement across-the-board cuts in federal spending of two percent starting in January 2013. Laboratory services will most likely be subject to that cut also. Even if Congress enacts to forestall the automatic cuts, clinical laboratories could still be part of any deficit reduction package.

GAU will continue to monitor and report on budget activities affecting the clinical laboratory community. If you would like a summary of the recent measure cutting laboratory payments, please visit the House Ways and Means Web site.

GAO Releases New Report Analyzing Use of Preventive Services

In January, the General Accountability Office (GAO) released a new report, the “Use of Preventive Services Could Be Better Aligned with Clinical Recommendations,” to find out whether Medicare fee-for-service beneficiaries use of preventive services is aligned with the recommendations of the US Preventive Services Task Force (USPSTF). The GAO found mixed results. Some services, such as mammograms and colorectal screening were underutilized based on USPSTF recommendations, whereas others, like prostate screening, were overutilized. The congressional investigative group is recommending that Congress require beneficiary cost-sharing for any preventive service that fails to get Task Force approval. A copy of the report is available on the GAO Web site.

HHS Announces Progress in Adoption of Health IT; Releases Proposed Rule

Kathleen Sebelius, the Secretary of the Department of Health and Human Services, recently announced a significant increase in the number of hospitals using electronic health records (EHRs), from 16 percent to 35 percent over the past few years. Much of the expansion results from the availability of federal IT incentive payments, according to the Secretary. A survey of hospitals indicates that by 2015, 85 percent plan to take advantage of Medicare and Medicaid IT incentive payments.

In conjunction with the announcement, HHS released a proposed rule outlining the second phase of its EHR incentive payments, including a list of additional clinical quality measures for comment that may be implemented in 2014. For a copy of the HHS announcement, please visit the Department Web site. To view the proposed rule, please visit the Federal Register Web site.

House Rep. Introduces Bill to Repeal PCORI

Representative Brett Guthrie (R-KY) introduced legislation, H.R.3827, to eliminate the Patient-Centered Outcomes Research Institute (PCORI) created by the 2010 health care reform law. The measure would also rescind the remaining funds allocated to the Agency for Healthcare Research and Quality (AHRQ) for comparative effectiveness research (CER) under the 2009 American Recovery and Reinvestment Act and use them to reduce the deficit. A copy of the bill is available on the congressional Web site, THOMAS. AACC has opposed similar legislation in the past. To see AACC’s views on this issue, please visit our Position Statements page click here.