If things went as planned, CMS had intended to determine whether competitive bidding could lower Medicare's bill for laboratory services without harming quality or patient access. However, two healthcare systems and a clinical laboratory have filed suit to stop the planned three-year project, which would have replaced the existing Medicare fee schedule for lab services in around San Diego.
Sharp HealthCare and Scripps Health, both San Diego-based health systems, operate labs that provide a high volume of outpatient services to patients who see their affiliated physicians. In their complaint, the two systems contended that forced competitive bidding for lab services would negatively impact the integrated delivery of care. Meanwhile, Internist Laboratory of Oceanside, CA, is objecting on different grounds. Because it provides only a small fraction of the 303 coded services it will be required to bid on, the new rules would force it to work with competitors to meet Medicare's requirements.
CMS plans to stop taking bids on February 15th unless a judge grants an injunction.
To learn more about the dispute:
- read this Modern Healthcare piece