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Groups Support Bill to Change Medicare Diagnostic Reimbursements

November 7, 2007

Several medical groups are supporting H.R. 1321, the Medicare Advanced Laboratory Diagnostics Act, saying it would fix Medicare’s outdated payment policies for diagnostic tests.

The bill would update Medicare’s reimbursement policies to encourage development of new diagnostic laboratory tests by establishing a demonstration project to evaluate new ways to code and pay for clinical diagnostic laboratory tests.

Medicare’s current payment policies for diagnostic tests are “insufficient and antiquated,” based on a fee schedule established in 1984, bill sponsor Rep. Bobby Rush (D-Ill.) said. He added that the policies discourage the development of new tests.

H.R. 1321 also would correct insufficiencies in the Medicare fee schedule for clinical tests, allowing treatments to start earlier, Rep. Donna Christensen (D-Virgin Islands) said. The bill would increase transparency in setting fees for diagnostic tests.

AdvaMed President and CEO Stephen Ubl noted the bill could have a chance to be included in upcoming Medicare legislation from Sens. Chuck Grassley (R-Iowa) and Max Baucus (D-Mont.). Because the bill is a demonstration project, he added, it would not be a high-cost item.

H.R. 1321 was referred to the House Subcommittee on Health earlier this year. More information on the bill can be seen at thomas.loc.gov/cgi-bin/bdquery/z?d110:h.r.01321:.