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Singular views of the year ahead: dodging "bullets" in 2006?

The clinical laboratory industry dodged several bullets in 2005. Congressional budget reconciliators, looking for offsets to help fund hurricane-relief efforts, avoided the temptation to restore patient co-payments or otherwise trim reimbursement levels for Medicare lab services; several states shelved proposals to impose co-pays or competitive bidding programs for Medicaid lab services. AMT sees the following as key next year:

* The personnel shortage will worsen, shrinking availability of qualified laboratorians and increasing stress on already stressed personnel.

* Small independent/hospital outreach labs will have a difficult time hanging onto their client base in the two metropolitan statistical areas where CMS' competitive-bidding demos take place, increasing concerns of smaller U.S. labs should those prove successful in CMS' eyes.

* As large managed-care companies play hardball with labs (e.g., by seeking national single-provider contracts), smaller labs will find it difficult to compete, causing further consolidation.

* As insurance carriers move to competitive bidding for managed healthcare products, expect CMS to be more aggressive in implementing its "substantially in excess" rules.

* Co-payments and competitive acquisition for state Medicaid lab services will continue to be an issue.

* CMS must face what to do in light of the high rate of deficiencies noted when conducting inspections of waived-testing labs. Personnel in these settings will be affected.

* If the lab industry pulls together to aggressively promote an increase in the "draw fee"--frozen for 20 years--we may have a good chance to realize an approximately $2.50 increase per requisition, a benefit to all labs.

* Several states may join California in requiring phlebotomist licensure or certification; and, while such initiatives may surface, they will likely fail due to an antiregulatory political climate and opposition by hospital and pathology groups.

All these issues will have an impact on medical laboratory professionals as they strive to deliver quality service with fewer resources.

--Christopher A. Damon, JD

Executive Director

American Medical Technologists (AMT)

Park Ridge, IL
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Title Annotation:Congressional budget reconciliators
Author:Damon, Christopher A.
Publication:Medical Laboratory Observer
Geographic Code:1USA
Date:Dec 1, 2005
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