A woman holding a megaphone with protesters around her holding signs.

AACC is renewing its support of the Saving Access to Laboratory Services Act (SALSA), which would reform the Medicare clinical laboratory fee schedule (CLFS). The current payment methodology set forth in the Protecting Access to Medicare Act (PAMA) has resulted in deeper lab payment cuts than Congress intended, said an AACC letter to Representative Richard Hudson (R-N.C.), a member of the House Energy and Commerce Subcommittee on Health.

The bill was reintroduced this year by Sens. Sherrod Brown (D-Ohio) and Thom Tillis (R-N.C.), along with Reps. Richard Hudson (R-N.C.), Bill Pascrell, Jr. (D-N.J.), Gus Bilirakis (R-Fla.), Scott Peters (D-Calif.), and Brian Fitzpatrick (R-Pa.).

PAMA, which was passed in 2014, directed the Centers for Medicare and Medicaid Services (CMS) to rebase the CLFS to reflect private sector payment rates. However, nearly all the data used to set the new fees comes from large commercial laboratories, which can perform testing at sharply reduced costs due to their economies of scale. This has resulted in significant reductions in payment rates that are adversely affecting all laboratories.

According to the Medicare Payment Advisory Commission, the CMS cuts have reduced reimbursement to hospitals and physician offices for testing services by 9% and 6%, respectively. This trend is expected to continue and may force some labs, particularly those in rural and underserved areas, to curtail or eliminate testing.

The SALSA bill would deal with several deficiencies in the earlier PAMA statute, according to the letter. These include the use of statistical sampling to ensure that CMS obtains more representative payment data for setting fees, providing greater price stability by placing limits on payment increases and decreases, and reducing the administrative burden on laboratories.

Lab professionals are encouraged to use AACC’s Laboratory Voice tool to write to their members of Congress: www.myadlm.org/advocacy-and-outreach/laboratory-voice


AACC is working with several coalitions to advocate for greater funding from Congress for the Centers for Disease Control and Prevention (CDC).

The largest initiative, called the CDC Coalition, includes 143 other members and is calling for $11.581 billion for CDC programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill.

“Due to years of underfunding, many CDC programs have not received the resources that are needed to address the many health challenges we face as a nation, resulting in many of CDC’s most effective prevention programs not reaching all states and communities,” wrote the coalition in a letter to Congress.

The coalition noted that CDC serves as the “command center” for the public health defense system against emerging and reemerging infectious diseases, as well as man-made and natural disasters. CDC also faces other “unprecedented challenges and responsibilities,” such as chronic disease prevention. At AACC’s urging, CDC also has been supporting harmonization of clinical laboratory results.

Separately, AACC has joined with a group of professional societies, academic institutions, and companies that are urging Congress to provide $175 million in funding for the Advanced Molecular Detection (AMD) program at CDC. The funding aligns with the level authorized in the Tracking Pathogens Act, which was enacted as part of a year-end legislative package in 2022.

The AMD program uses cutting-edge genomic and bioinformatic technologies to detect and respond to infectious disease threats, including the ongoing COVID-19 pandemic.

Beyond pathogen surveillance, the program also informs vaccine development, helps to identify and track antimicrobial resistance and foodborne illness, and informs the development of diagnostics for new, existing, and emerging diseases.

The program also has expanded training for public health and laboratory professionals in genomics and bioinformatics.