Laboratory News

Impending San Diego Lab Competitive Bid Demo Is Lab Industry Turning Point

It is bad enough that Medicare officials will proceed to implement a poorly-designed, flawed pilot site in the impending Laboratory Competitive Bidding Demonstration Project, scheduled for the San Diego-Carlsbad-San Marcos MSA (metropolitan statistical area) this year. But that is not the major story, for officials from the Centers for Medicare & Medicaid Services (CMS) are ready to use the bids submitted for the bidding demonstration on February 15, 2008 as the basis for a new national Part B laboratory fee schedule to be urged on Congress for as early as fiscal year 2009!

This intent was disclosed during the eight-hour bidders' meeting in San Diego on December 5. In the afternoon, in response to a questions from lab managers in attendance, a CMS official stated that, even if the San Diego competitive bidding demonstration pilot, scheduled for implementation on July 1, 2008, was delayed or canceled, that CMS would use the prices submitted by laboratory bidders on February 15 as the "prototype" for a new national Part B laboratory fee schedule it would recommend to Congress for action as early as fiscal year 2009.

Recognizing the significance of this new development, in the weeks since December 5, The Dark Report  prepared a special issue that provides the laboratory medicine profession with a comprehensive assessment of the Laboratory Competitive Bidding Demonstration Project. This issue is fresh off the printing press and heading to clients and subscribers now.

It provides intelligence about many facets of the Medicare competitive bidding demonstration project as yet unpublicized. The Dark Report predicts that, unless a unified laboratory medicine establishment takes swift action to derail the planned submission of bids on February 15, CMS will indeed take these bids and act rapidly to build a new national Part B laboratory fee schedule. In so doing, CMS is likely to make implementation of the two laboratory competitive bidding demonstration pilot sites a moot point. Further, CMS officials will craft this new national Part B laboratory fee schedule out of sight, denying laboratories the opportunity to comment on its design and structure.

In this special issue of The Dark Report, Editor and Publisher Robert Michel issues a call to action for the lab profession. He outlines steps the lab industry might take in response to the challenges triggered by this new development, since events in the next few months have the potential to change how all clinical labs across the nation do business with Medicare.

Readers will learn about the long history of laboratory competitive bidding at CMS, which starts in the early 1980s. They will learn how CMS and its contractor have designed and developed this bidding demonstration process without involving the voice of Medicare beneficiaries, the voice of the physician and provider community, or the voice of the laboratory medicine profession. In fact, the plan made public by CMS for the December 5 bidders' meeting was essentially the same plan it first made public in 1998!

Current clients and subscribers to The Dark Report will receive this issue via regular mail delivery. Because of the importance of this topic to the entire laboratory profession, The Dark Report will make single copies of this issue available to readers of Dark Daily, upon their request. Send an e-mail to: info@darkdaily.com and include your name and a postal mailing address. Further, if after reading this issue, you have additional comments or insights, please send them along to us. We will be pleased to share them with the full readership of Dark Daily.