Medical Labs Sue US Government Over Medicare Fees

The American Clinical Laboratory Association claims that scheduled reimbursements for tests are too low and could put small companies out of business.

kerry grens
| 1 min read

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WIKIMEDIA, U.S. NAVY PHOTO BY MASS COMMUNICATION SPECIALIST 2ND CLASS CHELSEA A. BLOMThe American Clinical Laboratory Association (ACLA) has filed a lawsuit against the US government for what it considers to be unfair payments for tests covered by Medicare, the federal health insurance program for seniors. At stake is about $670 million in payments for testing services that the ACLA says the government is shortchanging companies, according to Reuters.

The complaint stems from a 2014 law that aimed to ensure Medicare was paying about the same as private insurers for medical tests. To determine a fair price, the government surveyed clinical testing companies for their rates, but the ACLA claims that it reviewed only a small fraction of the market—namely, large firms that turn around a high volume and charge comparatively less than smaller ones.

According to Reuters, the lawsuit claims that less than 1 percent of the medical testing market had submitted fee rates to the Department of Health and Human Services, which runs Medicare.

“It is reckless and damaging to Medicare beneficiaries for the [Health and Human Services] Secretary to implement a payment system based on a specious data collection process that ...

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  • kerry grens

    Kerry Grens

    Kerry served as The Scientist’s news director until 2021. Before joining The Scientist in 2013, she was a stringer for Reuters Health, the senior health and science reporter at WHYY in Philadelphia, and the health and science reporter at New Hampshire Public Radio. Kerry got her start in journalism as a AAAS Mass Media fellow at KUNC in Colorado. She has a master’s in biological sciences from Stanford University and a biology degree from Loyola University Chicago.

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