This is a companion article to the Inside Track column, “(Still) the Next Big Thing.” 

Throughout the long period of gestation leading to implementation of a private payor-based pricing system for clinical lab testing, laboratorians and their professional associations have been active in providing comment about potential flaws in the system. Recent comments from those associations suggest that an even stronger effort is on the way, now that the Centers for Medicare and Medicaid Services (CMS) has released its proposed pricing schedule for 2018. In addition to working through professional associations, laboratorians can also submit their views directly by way of the following routes.

The period for submitting comments to CMS ended on October 23, 2017. However, individual members of Congress can also have an effect, potentially by encouraging CMS and the secretary of HHS to delay implementation of the PAMA fee schedule. Laboratorians can identify their members of Congress by visiting and entering their zip code; senators, by state, can be found at

The National Independent Laboratory Association (NILA) offers model letters for community and independent labs to send to Congress, and for hospital and health system laboratories to send directly to the office of the secretary of HHS. The letters include highlighted sections where laboratorians should place their own identifying information before e-mailing the documents. The model letters can be downloaded from the NILA website at