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AdvaMed concerned about lab competitive billing

Device Regulation Alert: Safety, Compliance and Reimbursement News, October 29, 2007

AdvaMed has expressed concern about how a competitive bidding demonstration project for clinical laboratories will affect patient care.

CMS announced this month that the first competitive bidding demonstration site for the legislatively mandated project would be the San Diego-Carlsbad-San Marcos, California, area. The project requires qualifying laboratories in that area to bid on specific laboratory services provided to Medicare beneficiaries.

AdvaMed's October 17 press release criticized the project for focusing on cost rather than quality and patient benefit. It also expressed concern that competitive bidding could adversely affect access to laboratory services.

The press release also notes that AdvaMed is continuing to support the proposed Medicare Advanced Laboratory Diagnostics Act to promote development of new clinical laboratory diagnostic tests. See our March 12 issue for more information about that Act.

The Medicare Prescription Drug, Improvement and Modernization Act of 2003 requires CMS to conduct a competitive bidding demonstration project for laboratory services paid under Medicare Part B. The project's purpose is to determine whether competitive bidding will lead to reduced fees to Medicare for clinical laboratory services without sacrificing quality and access. The project excludes certain laboratory tests such as Pap smears and colorectal screenings and only applies to face-to-face encounters with patients. Some laboratories, such as small laboratories with less than $100,000 in annual Medicare payments, aren't required to participate in the bidding. Proposed legislation would repeal the competitive bidding mandate.

Click here to read more about Medicare's Demonstration Project for Competitive Bidding of Clinical Laboratory Services, then click on the link under "Demonstration."

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