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ACLA Asks Federal Court to Strike Down Part of PAMA Rule

NEW YORK – The American Clinical Laboratory Association (ACLA) yesterday asked a federal court to strike down provisions in the final rule from the US Department of Health and Human Services implementing the Protecting Access to Medicare Act (PAMA).

In a motion for summary judgment filed in the US District Court for the District of Columbia, ACLA alleges that the process implemented by HHS for collecting payment data to set test reimbursement rates under PAMA was flawed and resulted in payment rates well below those paid by private insurers. ACLA wants the court to strike down certain parts of HHS' final rule "as unreasonable and contrary to PAMA's requirement" it said in a statement.

ACLA originally sued HHS and Azar in 2017 alleging the Medicare program did not follow a congressional direction to implement a market-based laboratory payment system because the rates used to determine PAMA rates were not collected in the way Congress intended. The association wants HHS to eliminate provisions in its final PAMA rules that exempt "thousands of laboratories from the reporting obligations that Congress imposed," according to the lawsuit's complaint. 

In its motion filed on Monday, ACLA said "Because the data-collection parameters imposed by the final rule have resulted in [HHS Secretary Alex Azar] establishing payment rates that are far below private-sector rates, some laboratories face a serious threat of being forced out of business, others are being forced to scale back essential services, and patients are being deprived of the services they need." 

The motion follows a July decision by the US Court of Appeals for the District of Columbia in favor of ACLA that overturned a lower court decision that dismissed the lab association's lawsuit due to a "lack of subject matter jurisdiction."