Clinical laboratories are an essential part of the health care decision making process. While less than 2 percent of all Medicare spending, more than 70 percent of all medical decisions are made based on the result of a lab test. Clinical labs also play a huge role in saving health care dollars through early diagnosis and maintenance of chronic conditions. Despite these clear benefits, clinical lab services are under attack on several fronts as Congress looks for savings in Medicare.
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Options being discussed include direct cuts to the clinical laboratory fee schedule as well as a possible new cost sharing requirements that would force seniors to pay part of the cost of all of their lab tests.
There is currently no cost sharing for clinical laboratory tests paid for under Medicare Part B. Cost sharing for laboratory services has been rejected by Congress multiple times over the past ten years, most recently during health reform.
Cost sharing—whether that be a uniform coinsurance or a direct copay for beneficiaries—would have a negative consequence for patients and the providers that perform their laboratory testing. When a beneficiary cannot pay, the labs would be responsible for the costs. For many labs, especially small community labs who primarily serve the Medicare population, this will threaten the existence of their business.
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