Laboratory Access for Beneficiaries Act

To amend title XVIII of the Social Security Act to provide for certain amendments relating to reporting requirements with respect to clinical diagnostic laboratory tests, and for other purposes. 1. Short title This Act may be cited as the Laboratory Access for Beneficiaries Act LAB Act 2. Amendments relating to reporting requirements with respect to clinical diagnostic laboratory tests (a) Revised reporting period for reporting of private sector payment rates for establishment of Medicare payment rates Section 1834A(a) of the Social Security Act ( 42 U.S.C. 1395m–1(a) (1) in paragraph (1)— (A) by striking Beginning January 1, 2016 (A) General reporting requirements Subject to subparagraph (B), beginning January 1, 2016 ; and (B) by adding at the end the following: (B) Revised reporting period In the case of reporting with respect to clinical diagnostic laboratory tests that are not advanced diagnostic laboratory tests, the Secretary shall revise the reporting period under subparagraph (A) such that— (i) no reporting is required during the period beginning January 1, 2020, and ending January 1, 2021; (ii) reporting is required during the period beginning January 1, 2021, and ending March 31, 2021; and (iii) reporting is required every three years after the period described in clause (ii). ; and (2) in paragraph (4)— (A) by striking In this section (A) In general Subject to subparagraph (B), in this section ; and (B) by adding at the end the following: (B) Exception In the case of reporting during the period described in paragraph (1)(B)(ii) with respect to clinical diagnostic laboratory tests that are not advanced diagnostic laboratory tests, the term data collection period . (b) Corrections relating to phase-In of reductions from private payor rate implementation Section 1834A(b)(3) of the Social Security Act ( 42 U.S.C. 1395m–1(b)(3) (1) in subparagraph (A), by striking through 2022 through 2023 (2) in subparagraph (B)— (A) in clause (i), by striking through 2019 through 2020 (B) in clause (ii), by striking 2020 through 2022 2021 through 2023 3. Study and report by National Academy of Medicine (a) In general Not later than 90 days after the date of the enactment of this Act, the Administrator of the Centers for Medicare & Medicaid Services (referred to in this section as the Administrator National Academies 42 U.S.C. 1395 (b) Scope of study In carrying out the study described in subsection (a), the National Academies shall consider the following: (1) How best to implement the least burdensome data collection process required under section 1834A(a)(1) of such Act ( 42 U.S.C. 1395m–1(a)(1) (A) result in a representative and statistically valid data sample of private market rates from all laboratory market segments, including hospital outreach laboratories, physician office laboratories, and independent laboratories; and (B) consider the variability of market segments by laboratory procedure code. (2) Appropriate statistical methods for estimating rates that are representative of the market. (c) Report to Congress Not later than the date that is 18 months after the Administrator enters into the agreement described in subsection (a) with the National Academies, the National Academies shall submit to the Administrator, the Committee on Finance of the Senate, and the Committees on Ways and Means and Energy and Commerce of the House of Representatives a report that includes— (1) conclusions about the methodology described in such subsection; and (2) recommendations on ways to improve such methodology.

Summary: Laboratory Access for Beneficiaries Act or the LAB Act This bill revises the periods during which laboratories must report clinical diagnostic test information to the Centers for Medicare & Medicaid Services (CMS) for purposes of determining Medicare payment rates. The CMS must also contract with the National Academies of Sciences, Engineering, and Medicine to evaluate the methodology used to determine a specified laboratory fee schedule.