[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3453 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 3453

To amend title XVIII of the Social Security Act to repeal the Medicare 
   competitive bidding demonstration project for clinical laboratory 
                               services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 4, 2007

Ms. Velazquez introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
   Ways and Means, Judiciary, and Small Business, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to repeal the Medicare 
   competitive bidding demonstration project for clinical laboratory 
                               services.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Community Clinical Laboratory 
Fairness in Competition Act of 2007''.

SEC. 2. FINDINGS; POLICY.

    (a) Findings.--The Congress finds the following:
            (1) The Centers for Medicare & Medicaid Services of the 
        Department of Health and Human Services (HHS) estimated that 
        there are approximately 5,200 independent clinical laboratories 
        in the United States.
            (2) Independent clinical laboratories provide $16.3 billion 
        in Medicare services to many of the 40 million-plus Medicare 
        beneficiaries in the United States.
            (3) The laboratory results allow health care professionals 
        to make important diagnosis of their patients. While the tests 
        performed by clinical laboratories account for less than 2 
        percent of Medicare expenditures, they influence as much as 70 
        percent of medical decision-making.
            (4) Small labs often operate 24 hours a day, 7 days a week 
        to respond to hospital, nursing home, physician practices, and 
        urgent emergency care situations.
            (5) Nearly 5,000 independent clinical laboratories are 
        classified as small business concerns by the Small Business 
        Administration.
            (6) A wide variety of independent clinical labs exist in 
        the marketplace and serve the important function of providing 
        prompt access to diagnostic information that is crucial to 
        decision-making.
            (7) Most small independent clinical laboratories receive 40 
        percent of their revenue from Medicare.
            (8) The fee schedule and the formula for determining 
        payment amounts for Medicare services were established in 1984.  
         Although payment rates have changed over the past 20 years, 
        the basic methodology has not, and, according to many experts 
        inside and outside of the laboratory community, the methodology 
        is considered outdated.   In deciding a payment formula, it 
        must consider the potential   impact on small laboratories as 
        well as access to services for health care professionals and 
        the Medicare beneficiaries.
            (9) Competitive bidding would reduce the number of lab 
        service providers in the market, lessening the diversity of 
        labs currently competing by forcing smaller labs out of 
        business, and ultimately creating monopolies. The current 
        diversity among clinical laboratories has fostered price 
        competition and ensured patient access to lab services. 
        Allowing the marketplace, rather than the Federal government, 
        to drive competition will spur innovation and safeguard patient 
        access to lab services.
    (b) Policy.--It is the policy of the United States to--
            (1) promote and encourage competition in the market;
            (2) preserve the vibrant and competitive free market that 
        presently exist among independent clinical laboratories; and
            (3) encourage the continuation of industry best practices 
        that guarantee patient access to quality laboratory services.

SEC. 3. REPEAL OF MEDICARE COMPETITIVE BIDDING DEMONSTRATION PROJECT 
              FOR CLINICAL LABORATORY SERVICES.

    (a) In General.--Section 1847 of the Social Security Act (42 U.S.C. 
1395w-3) is amended by striking subsection (e).
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect on the date of the enactment of this Act.
    (c) Report.--The Administrator of the Centers for Medicare & 
Medicaid Services shall submit to issue a report to the Committee on 
Small Business of the House of Representatives and the Committee on 
Small Business and Entrepreneurship of the Senate providing an analysis 
of the impact of competitive bidding on small clinical laboratories.

SEC. 4. SMALL BUSINESS ADVOCACY REVIEW PANELS.

    Section 609(d) of title 5, United States Code, is amended by 
striking ``and the Occupational Safety and Health Administration of the 
Department of Labor'' and inserting ``, the Occupational Safety and 
Health Administration of the Department of Labor, and the Centers for 
Medicare & Medicaid Services of the Department of Health and Human 
Services (solely with respect to its capacity to issue rules governing 
the Medicare part B fee schedule for clinical laboratory services)''.
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