The Centers for Medicare & Medicaid Services (CMS) have selected the San Diego-Carlsbad-San Marcos, California metropolitan area as the first of two locations for a competitive bidding demonstration for clinical laboratory services provided to fee-for-service Medicare beneficiaries.
The demonstration, which was mandated by the Medicare Modernization Act of 2003, is designed to determine whether competitive bidding can be used to provide lab services under Medicare Part B at fees below current Medicare payment rates, while maintaining quality and access to care. Medicare paid nearly $6.7 billion to clinical labs in 2006.
A project Web page, a public project mailbox, and a project listserv will support ongoing communication with the public. CMS has publicly shared the proposed design for the demonstration at various stages of its development.
The demonstration will include labs providing services to beneficiaries enrolled in traditional fee-for-service Medicare and living in the demonstration area. Part B helps pay for medical services provided by labs, physicians, and other practitioners and suppliers, and covers clinical lab tests with no cost-sharing by beneficiaries.
A bidders conference is planned for October 31, 2007 in the San Diego-Carlsbad-San Marcos, California metropolitan area to help labs providing services to Medicare beneficiaries who live in the demonstration area understand the project’s purpose and how it will be implemented.
Beneficiaries and their physicians who order lab tests will still have a choice among various labs competing with each other on the basis of service and quality. Multiple winners will be selected based on bid price, quality, capacity, geographic coverage, and other non-price criteria.
For more information, visit www.cms.hhs.gov/center/clinical.asp and click on Demonstration.
