Pay rates for lab tests threaten access for long-term care beneficiaries, group warns

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Long-term care beneficiaries may be at risk under proposed reimbursement rates for clinical laboratory tests, the ​National Association for the Support of Long Term Care said on Tuesday.

The group, which represents ancillary product and service providers in the post-acute industry, expressed its “significant concerns” with the Centers for Medicare & Medicaid Services' draft lab test payment rates for calendar year 2018, which were published last week.

The potential rates could “inflict severe cuts” to labs, according to one industry group. Lab companies also spoke out to slam the rates.

Lab companies that provide tests for skilled nursing patients serve a “disproportionate” number of Medicare beneficiaries compared to the rest of the clinical lab industry, since Medicare is the main payer of services for those in long-term care. That leaves NASL's member lab companies to “shoulder the brunt of these massive lab fee cuts due to the patient population they serve,” NASL Executive Vice President Cynthia Morton said a statement.

The rates, set under the Protecting Access to Medicare Act of 2014, were supposed to follow a “market-based fee schedule that would provide savings and predictability for lab services,” Morton said. Instead, the CY 2018 draft rates focus on just a small segment of the clinical laboratory industry.

“As a result, the proposed rates are so low that they threaten beneficiary access — an outcome completely contrary to Congressional intent and the result of a failed implementation by CMS,” Morton said.

Alan Morrison, NASL vice president and chairman of the group's Diagnostic Testing Committee, also noted that “CMS' actions will be devastating to almost all labs serving this highly vulnerable population and such dramatic cuts simply cannot be absorbed by these labs by reducing their costs.”