October 18, 2007 - Update on Competitive Bidding Demonstration Project for Medicare Clinical Laboratory Services
The American Society for Microbiology (ASM) is writing to update you on the status of the Competitive Bidding Demonstration Project for Medicare Clinical Laboratory Services. A notice was published in the October 17 Federal Register announcing that the Centers for Medicare & Medicaid Services (CMS) had selected San Diego-Carlsbad-San Marcos, California as the first of two locations for the demonstration for clinical laboratory tests provided to fee-for-service beneficiaries under Medicare Part B. The demonstration was mandated by the Medicare Modernization Act of 2003 (MMA) to determine whether competitive bidding can be used to provide laboratory services at fees below current Medicare payment rates, while maintaining quality and access to care.
According to CMS, clinical laboratories that provide at least $100,000 annually in demonstration tests to Medicare fee-for-service beneficiaries residing in the San Diego-Carlsbad-San Marcos area will be required to submit bids for 303 test codes representing about 99 percent of the tests paid for by Medicare Part B. Winning laboratories will be paid the competitively set demonstration rates. Required bidders that do not bid, or that bid and do not win, may serve as a reference laboratory for labs participating in the demonstration, but may not bill Medicare directly for demonstration tests.
CMS will host a Bidders Conference in the San Diego-Carlsbad-San Marcos Metropolitan Statistical Area (MSA) on October 31, 2007 to answer questions about the demonstration project and to assist clinical laboratories who serve Medicare beneficiaries in the MSA with the bidding process. There are no additional details at this time regarding the time or location for this meeting.
As you know, the ASM has joined with other organizations in stating collective concerns about the demonstration project. If you have not already done so, please send a letter to your Member of Congress, to urge them to support legislation aimed at stopping this program. Please visit ASM's Legislative Communications Site where you can send an email today regarding this important matter. Thank you.
Susan E. Sharp, Ph.D., Chair, Committee on Laboratory Practices
ASM Public and Scientific Affairs Board