110 HR 3453 IH: Community Clinical Laboratory Fairness U.S. House of Representatives 2007-08-04 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I 110th CONGRESS 1st Session H. R. 3453 IN THE HOUSE OF REPRESENTATIVES August 4, 2007 Ms. Velázquez 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.

1.

Short title

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

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.

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.

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).