"The elimination of cost-based reimbursements for these services will disrupt care for frail and elderly Medicare patients who may now have to travel long distances to the hospital to have their laboratory specimens drawn," said Senator Susan Collins. "The legislation we are proposing will restore these payments to ensure that Medicare patients living in rural communities continue to have access to convenient and affordable laboratory services."
Congress created the Critical Access Hospital (CAH) program in 1997 to ensure that Americans living in isolated, rural communities had access to health care. Critical access hospitals are often a community''s only source of health care services. To protect their viability, Congress authorized cost-based reimbursement for Medicare inpatient and outpatient services provided by these hospitals, regardless of where the services were provided.
A recent clarification by the Centers for Medicare and Medicaid Services (CMS), however, has changed this policy. Cost-based reimbursements will no longer be provided for laboratory services unless the patient is physically present in the hospital when the laboratory specimen is collected. Since critical access hospitals are often the main source of health care in the community, they frequently provide laboratory services in other settings such as community health centers, skilled nursing facilities, and even the patient''s home. The elimination of cost-based reimbursement for these services may make it prohibitive for these hospitals to continue to offer off-site laboratory testing. ###