The Continuing Appropriations and Extensions Act, 2025 (H.R. 9747) became law on Sept. 25, averting a government shutdown and delaying Medicare cuts of up to 15 percent for nearly 800 laboratory services.
Under the Protecting Access to Medicare Act (H.R. 4302), private market data are used to determine Clinical Laboratory Fee Schedule (CLFS) payment rates, but the first round of data collection included less than 1 percent of laboratories and did not accurately capture laboratory test payments, according to the American Clinical Laboratory Association (ACLA). The most recent Medicare payment reductions and associated data reporting periods for the CLFS were set to take effect in January 2025 but are now delayed for one year, set to take effect in January 2026.
“There is widespread and bipartisan recognition that long-term reform is urgently needed,” ACLA President Susan Van Meter said in a press release. “A sustainable reform of the Medicare payment system for clinical laboratory services is vital to protect and enhance patient care, foster innovation, and ensure the stability of clinical laboratories nationwide.”
ACLA and other stakeholders continue to advocate for passage of the Saving Access to Laboratory Services Act, or SALSA (H.R. 2377/S. 4449), which would require payment rates for clinical diagnostic laboratory tests to be based on a statistical sample of private sector rates and would be a permanent correction of the PAMA provisions related to CLFS payment rates.
Sources:
https://www.appropriations.senate.gov/imo/media/doc/fy25_section_by_section1.pdf
https://www.acla.com/saving-access-to-laboratory-services-act/
