Raising the out-of-pocket costs for Medicare beneficiaries with Medigap policies not likely to be favorable for medical laboratories
If federal officials have their way, Medicare beneficiaries with comprehensive Medigap polices are likely to pay a greater share of the cost of their medical care. The goal is to reduce use of unnecessary medical services and save Medicare money.
For clinical laboratories and anatomic pathology groups, this may not be a welcome development. That’s because any requirement for labs to collect more money directly from Medicare beneficiaries will raise the cost of billing and collections—even as medical laboratories also see a rise in bad debt from Medicare beneficiaries, who are not accustomed to paying any money out-of-pocket for most of their medical laboratory tests.
May Be Some Good News for Pathologists
However, there is some good news for pathologists and clinical laboratory managers in this story. A credible source has warned the federal government that increasing the Medicare beneficiary’s costs will not reduce unnecessary utilization of healthcare services. Nor will it save the Medicare program any money. In fact, such actions may have the opposite effect!
The government is considering requiring higher out-of-pocket cost sharing from the 9 million seniors with Medigap policies to cut down on use of unnecessary medical services. The National Association of Insurance Commissioners contend, however, that this would raise Medicare costs over time. (Graphic by Kaiser Health News)
Draft language of new rule would change existing requirements on access to medical laboratory test results as defined in CLIA and HIPAA laws
Big changes lie ahead in how clinical laboratories and pathology groups must give patients access to their medical laboratory test results. Last week, federal agencies published a draft rule that specifies how patients or their authorized representatives are to be given direct access to their medical laboratory test results.
This draft rule was made public on September 12 by the Department of Health and Human Services (HHS), along with the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), and the HHS Office for Civil Rights. Two days later, on September 14, the proposed rule was published in the Federal Register. There will be a 60-day period from the date of this publication for public comment on the proposed rule. (more…)
Recent federal court case and a columnist in the Weekly Standard illustrate how Boomers are ready to challenge existing Medicare laws they don’t like
Will the oldest Baby Boomers, now turning 65 years old this year, accept enrollment in the Medicare program or will they challenge it—as they have challenged many other institutions in American society over their lifetimes? News outlets are already reporting instances of Baby Boomers fighting to keep their existing private health insurance, for example.
If this is a trend that sets down deep roots, it can also trigger significant changes in the clinical laboratory testing marketplace. Were Baby Boomers to file lawsuits in federal courts that are settled in their favor, for example, it could pave the way for Boomers to retain private health insurance in lieu of enrollment in fee-for-service Medicare or the Medicare Advantage Plans.