LAB Act

II 116TH CONGRESS 1ST SESSION S. 3049 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. IN THE SENATE OF THE UNITED STATES DECEMBER 12, 2019 Mr. BROWN (for himself and Mr. BURR) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to provide for certain amendments relating to reporting require- ments with respect to clinical diagnostic laboratory tests, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Laboratory Access for 4 Beneficiaries Act’’ or the ‘‘LAB Act’’. 5 VerDate Sep 11 2014 03:51 Dec 17, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3049.IS S3049 kjohnson on DSK79L0C42 with BILLS 2 •S 3049 IS SEC. 2. AMENDMENTS RELATING TO REPORTING REQUIRE- 1 MENTS WITH RESPECT TO CLINICAL DIAG- 2 NOSTIC LABORATORY TESTS. 3 (a) REVISED REPORTING PERIOD FOR REPORTING 4 OF PRIVATE SECTOR PAYMENT RATES FOR ESTABLISH- 5 MENT OF MEDICARE PAYMENT RATES.—Section 6 1834A(a) of the Social Security Act (42 U.S.C. 1395m– 7 1(a)) is amended— 8 (1) in paragraph (1)— 9 (A) by striking ‘‘Beginning January 1, 10 2016’’ and inserting the following: 11 ‘‘(A) GENERAL REPORTING REQUIRE- 12 MENTS.—Subject to subparagraph (B), begin- 13 ning January 1, 2016’’; 14 (B) in subparagraph (A), as added by sub- 15 paragraph (A) of this paragraph, by inserting 16 ‘‘(referred to in this subsection as the ‘reporting 17 period’)’’ after ‘‘at a time specified by the Sec- 18 retary’’; and 19 (C) by adding at the end the following: 20 ‘‘(B) REVISED REPORTING PERIOD.—In 21 the case of reporting with respect to clinical di- 22 agnostic laboratory tests that are not advanced 23 diagnostic laboratory tests, the Secretary shall 24 revise the reporting period under subparagraph 25 (A) such that— 26 VerDate Sep 11 2014 03:51 Dec 17, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3049.IS S3049 kjohnson on DSK79L0C42 with BILLS 3 •S 3049 IS ‘‘(i) no reporting is required during 1 the period beginning January 1, 2020, and 2 ending December 31, 2020; 3 ‘‘(ii) reporting is required during the 4 period beginning January 1, 2021, and 5 ending March 31, 2021; and 6 ‘‘(iii) reporting is required every three 7 years after the period described in clause 8 (ii).’’; and 9 (2) in paragraph (4)— 10 (A) by striking ‘‘In this section’’ and in- 11 serting the following: 12 ‘‘(A) IN GENERAL.—Subject to subpara- 13 graph (B), in this section’’; and 14 (B) by adding at the end the following: 15 ‘‘(B) EXCEPTION.—In the case of the re- 16 porting period described in paragraph (1)(B)(ii) 17 with respect to clinical diagnostic laboratory 18 tests that are not advanced diagnostic labora- 19 tory tests, the term ‘data collection period’ 20 means the period beginning January 1, 2019, 21 and ending June 30, 2019.’’. 22 (b) CORRECTIONS RELATING TO PHASE-IN OF RE- 23 DUCTIONS FROM PRIVATE PAYOR RATE IMPLEMENTA- 24 VerDate Sep 11 2014 03:51 Dec 17, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3049.IS S3049 kjohnson on DSK79L0C42 with BILLS 4 •S 3049 IS TION.—Section 1834A(b)(3) of the Social Security Act 1 (42 U.S.C. 1395m–1(b)(3)) is amended— 2 (1) in subparagraph (A), by striking ‘‘through 3 2022’’ and inserting ‘‘through 2023’’; and 4 (2) in subparagraph (B)— 5 (A) in clause (i), by striking ‘‘through 6 2019’’ and inserting ‘‘through 2020’’; and 7 (B) in clause (ii), by striking ‘‘2020 8 through 2022’’ and inserting ‘‘2021 through 9 2023’’. 10 SEC. 3. STUDY AND REPORT BY MEDPAC. 11 (a) IN GENERAL.—The Medicare Payment Advisory 12 Commission (in this section referred to as the ‘‘Commis- 13 sion’’) shall conduct a study to review the methodology 14 the Administrator of the Centers for Medicare & Medicaid 15 Services has implemented for the private payor rate-based 16 clinical laboratory fee schedule under the Medicare pro- 17 gram under title XVIII of the Social Security Act (42 18 U.S.C. 1395 et seq.). 19 (b) SCOPE OF STUDY.—In carrying out the study de- 20 scribed in subsection (a), the Commission shall consider 21 the following: 22 (1) How best to implement the least burden- 23 some data collection process required under section 24 VerDate Sep 11 2014 03:51 Dec 17, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3049.IS S3049 kjohnson on DSK79L0C42 with BILLS 5 •S 3049 IS 1834A(a)(1) of such Act (42 U.S.C. 1395m–1(a)(1)) 1 that would— 2 (A) result in a representative and statis- 3 tically valid data sample of private market rates 4 from all laboratory market segments, including 5 hospital outreach laboratories, physician office 6 laboratories, and independent laboratories; and 7 (B) consider the variability of private 8 payor payment rates across market segments 9 and laboratory setttings. 10 (2) Appropriate statistical methods for esti- 11 mating rates that are representative of the market. 12 (c) REPORT TO CONGRESS.—Not later than 18 13 months after the date of the enactment of this Act, the 14 Commission shall submit to the Administrator, the Com- 15 mittee on Finance of the Senate, and the Committees on 16 Ways and Means and Energy and Commerce of the House 17 of Representatives a report that includes— 18 (1) conclusions about the methodology de- 19 scribed in such subsection; and 20 (2) any recommendations the Commission 21 deems appropriate. 22 Æ VerDate Sep 11 2014 03:51 Dec 17, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S3049.IS S3049 kjohnson on DSK79L0C42 with BILLS