SALSA legislation will help protect labs and patients by addressing the shortcomings of the 2014 Protecting Access to Medicare Act.

By Kristina Martin, MS, MLS(ASCP)CM

“Every important change in our society, for the good, at least, has taken place because of popular pressure-pressure from below, from the great mass of people.” –Edward Abbey

Members of several laboratory professional societies representing 40 different states arrived on Capitol Hill at the end of September 2022 to be the voice of the laboratory profession.  This included the American Society for Clinical Laboratory Science (ASCLS), American Society for Clinical Pathology (ASCP), Association of Genetic Technologists (AGT), American Medical Technologists (AMT), the National Society for Histotechnology (NSH), and the Philippine Association of Medical Technologists-USA (PAMET-USA). Several issues were discussed during the annual Laboratory Legislative Symposium including workforce shortage issues, LDT legislation, and the Saving Access to Laboratory Services Act (SALSA/H.R.8188/S.4449). 

The SALSA legislation was designed to address the shortcomings of the 2014 Protecting Access to Medicare Act (PAMA/P.L. 113-93) legislation that dramatically impacted the Medicare Clinical Laboratory Fee Schedule (CLFS) with significant year over year cuts. As many in the laboratory community know, these cuts have had a considerable impact for patients who routinely receive care from their local healthcare facilities, and essentially accomplished the opposite of its intent to “protect access” for vulnerable Medicare patients. The data collected to inform the implementation of PAMA did not account for most of the hospital outreach programs and testing that occurs in a physician office laboratory. Fortunately, Congress understood the impact that resulted from PAMA and delayed cuts three times since the initial implementation. However, counting on this action is not practical or sustainable for all parties involved, including the government.

The SALSA legislation provides a permanent, pragmatic approach to evaluating the CLFS, eliminating huge swings, either positive or negative as it pertains to Medicare reimbursement. It also allows for a more comprehensive evaluation of data to be collected from a broader sampling of laboratory sectors. Ensuring appropriate funding reimbursement for testing is an investment in our future. It allows for purchasing the latest technology for enhanced productivity and new test platforms, along with ensuring that institutions have the ability to provide competitive salaries for highly qualified staff.

Gaining traction for mission critical legislation such as SALSA is not a one-and-done effort. The contingent of laboratory professionals were successful in obtaining several cosponsors on both sides of Congress during our visit. This is a significant win to show the power of direct contact, however, it is critical for all laboratory professionals to engage their senators and representatives. We have seen the power of a unified voice in other legislative issues impacting the laboratory, and I would highly encourage everyone to make this connection using the information provided at the Legislative Symposium in the SALSA issues brief. If you aren’t aware of who to contact, you can use the congress.gov website to find your senator or representative. The full bill with information on cosponsors along with progress of H.R.8188 and S.4449 can be found online.

As we enter election season Congress will be looking to wrap up business and outstanding tasks. Now is the perfect time to make your voice heard about SALSA legislation and other legislative actions that affect clinical laboratories. Become a labvocate today!

About the Author

Kristina Martin, MS, MLS(ASCP)CM is clinical pathology operations director of the Department of Pathology for Michigan Medicine. She was part of a contingent of laboratorians who met with congressional leaders in Washington, DC, to support the pending SALSA legislation.