August 25, 2011

The forecast for Hurricane Irene, currently a Category 3 storm, is now expected to track farther inland along the East Coast than originally expected. That puts more people within the warning "cone" issued by the National Hurricane Center, which includes all of us.

If your Governor declares your State to be in a “State of Emergency” only the following personnel may be considered essential or may be eligible for travel restriction exemption:

• Police, fire and emergency medical services and authorized emergency management personnel

• Other persons providing emergency medical treatment or other assistance necessary to prevent an immediate threat to life

• Designated emergency government employees

• Persons who are employed, contracted or responsible for performing duties necessary to:

• Ensure maintenance of acceptable conditions at facilities providing health and medical care, veterinary and/or daily residential care facilities,

• Prevent an immediate danger to the public safety arising from unattended chemical, industrial or other processes involving hazardous materials,

• Restore, maintain or safely operate a public utility transportation or communication system

• Permit operations of a business for the purpose of providing fuel, heating, electrical, plumbing and other services necessary to prevent an immediate threat to the health, safety and welfare of the public

• Conduct news reporting activities

Brookside employees are not considered emergency personnel by definition of the states where we provide laboratory service.   We will resume service once the State of Emergency is lifted.

Web Reporting:
The IT Company we utilize and the server for your web reporting is located in South Jersey.   Hurricane Irene and its potential damage to our area may affect your ability to retrieve online results Monday and Tuesday.

April 5, 2011

GOOD NEWS FOR CLINICAL PATHOLOGY LABORATORIES!
CMS WILL NOT ENFORCE PHYSICIAN-SIGNATURE RULE

CMS officials have instructed carriers not to enforce the physician signature rule for paper requisitions for medical laboratory tests

Officials at the federal Centers for Medicare & Medicaid Services (CMS) will continue to delay enforcement of a rule requiring physician signatures on paper requisitions for medical laboratory tests. This is a positive development for all clinical laboratories and pathology groups in the United States.

What is an even more important development is that this rule may never be enforced, according to leaders from two of the nation’s laboratory associations. The entire medical laboratory testing industry has waited since the end of December for an official statement from CMS on enforcement of this rule.

It was learned, as of March 31, that CMS will not enforce the rule due to concerns raised by pathologists, lab directors, and other providers who were concerned about the negative effect this rule would have on patient care. It was back in December, 2010, when CMS officials had announced that they would delay enforcement of the rule, which took effect on January 1, 2011, until the second quarter of 2011 (which meant as early as April 1).

“After further input from the community, CMS remains concerned that physicians, non-physician practitioners (NPP), and clinical diagnostic laboratories are having difficulty complying with this policy,” CMS said in a transmittal to Medicare carriers on March 31. “For this reason, CMS is instructing its Medicare contractors not to enforce the requirement to have a physician or NPP signature on requisitions for clinical diagnostic laboratory tests paid under the clinical laboratory fee schedule.”

Alan Mertz, CEO of the American Clinical Laboratory Association (ACLA) in Washington, D.C., said, “This transmittal is consistent with everything we have heard from CMS recently, and we also have heard that CMS is likely never to enforce this rule. In fact, we have learned that CMS will seek to repeal the rule beginning this summer when it takes up the 2012 physician fee schedule.”

Last month, CMS sent an interim final rule to rescind the physician-signature requirement to the White House Office of Management and Budget. But ACLA and officials from the American Association of Bioanalysts (AAB) and other national associations representing labs have heard that the interim rule could not go forward and that CMS must go through the proper federal rulemaking process.

Mark S. Birenbaum, Ph.D., Administrator of the National Independent Laboratory Association (NILA), in St. Louis, Missouri, said it was significant that the Clinical Laboratory Coalition and other organizations representing providers, including the AMA, and the American Hospital Association, worked with members of Congress to recommend to CMS that the rule would have a negative effect on patient care.

“We believe the fact that 89 members of the House of Representatives and 34 members of the U.S. Senate signed a letter to CMS recommending that the rule should be repealed had a significant effect on the decision,” Birenbaum commented. “And those who signed the letter were both Republicans and Democrats and they were about equally split.”

Birenbaum also said that a video on YouTube that was produced by a member of NILA helped to explain the patient-care issues in a compelling manner. “When you see the video, you will notice that it was not produced by professional videographers,” Birenbaum explained. “Nonetheless, the video by Annette Iacono of Brookside Clinical Laboratory Inc. in Brookhaven, Pennsylvania, has a strong message about the effect this rule could have had on patients, physicians, and labs. Annette is vice president of Brookside Clinical Laboratory, and secretary-treasurer of NILA.”

To rescind this law, CMS will be taking specific steps. ACLA’s Mertz said that laboratories can expect the process to involve the following steps. “At some point later this year, we expect that CMS will issue a notice and request comments from the lab industry and other providers on rescinding the requirement officially,” Mertz explained.

“That notice might not be until the 2012 physician fee schedule is proposed this summer and it might not be made final in October or November of 2011,” he continued. “But the fact that the requirement will not be enforced until the rescission rule takes effect is significant because it shows what’s possible when a number of provider organizations, including the Clinical Laboratory Coalition, the American Medical Association, the American Hospital Association, and others can do when we work together.”

To read full article from the source, click here.

February 21, 2011

CMS TO WITHDRAW PHYSICIAN SIGNATURE RULE!

AAB/NILA heard from CMS first thing this morning that the agency has determined the physician signature rule is unworkable and that the best thing to do is to pull it back in its current form.

According to CMS, their intention was to verify the adequacy of payments being made for Part B laboratory services, but the rule itself does not achieve this and causes disruption and confusion. CMS wants to work with the laboratory community to reevaluate the issues.

An official notice revising the rule is forthcoming, and CMS is determining the best way to announce the change well in advance of April 1, 2011. We anticipate Congress may receive formal notice of this decision even sooner.

Thanks to AAB/NILA's hard work, bipartisan letters expressing concern over the rule from the House and Senate were forwarded to CMS last night. The House letter included 89 signatures from House Representatives. The Senate letter was signed by 34 Senators.

Thanks for your hard work on this issue!!!

Mark S. Birenbaum, Ph.D.
Administrator American Association of Bioanalysts
National Independent Laboratory Association

August 9, 2009

ALL MEDICARE BENEFICIARIES:
CONGRESS WANTS YOU TO PAY 20% OF THE COST EVERY TIME YOU HAVE CLINICAL LAB TESTS

URGENT

YOUR CURRENT MEDICARE BENEFIT             PROPOSED PLAN
ALL TESTS ARE COVERED 100%                        YOU PAY 20%
NO DEDUCTIBLE                                                YOU PAY DEDUCTIBLE

WHAT CAN YOU DO?
CALL SENATOR SPECTER:                    202-224-4254
CALL SENATOR CASEY:                        202-224-6324

TELL YOUR SENATORS: “NO 20% CO-PAYMENT FOR CLINICAL LAB TESTS”

CALL NOW – BEFORE IT IS TOO LATE!!!
TELL ALL YOUR FRIENDS WHO HAVE MEDICARE TO CALL THEIR SENATORS AND TELL THEM:  NO CO-PAYMENT FOR CLINICAL LAB TESTS

Vancomycin targets—tactics for tough foe

July 2009
Feature Story
William Check, PhD
Vancomycin and Staphylococcus aureus—long-time partners at the infectious disease dance. Monitoring and dosing guidelines for vancomycin to treat S. aureus infections were established decades ago. In the ever-changing world of laboratory medicine, it’s nice to know some practices are dependable. And yet—it seems all is not settled between these two. Witness the consensus review published in January titled “Therapeutic monitoring of vancomycin in adult patients” (Rybak M, et al. Am J Health-Syst Pharm. 2009;66:82–98), a joint document of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. The publication reviewed evidence regarding effective serum trough concentrations and dosing regimens for vancomycin amid suspicion that resistance in S. aureus strains has grown incrementally, as well as concern about an increase in therapeutic failures. The review contained a set of recommendations; also in the review was a discussion of potential toxicity and recommendations about when to monitor to avoid it. As a result, vancomycin and S. aureus look less like dancing partners and more like determined pugilistic adversaries in a long-running series of title fights. Like Ali and Frazier, they keep getting up off the canvas and returning for another round. As with much of infectious disease practice, it’s a real-time display of evolution in process.

Read more...

AARP to Congress: Don’t Make Medicare More Expensive

Source: AARP Press Center
FOR IMMEDIATE RELEASE
July 30, 2009

Contact:
AARP Media Relations, 202-434-2560

AARP to Congress: Don’t Make Medicare More Expensive

Association fighting proposals that would unfairly burden people in Medicare

WASHINGTON—AARP CEO Barry Rand today wrote to House Energy and Commerce Committee Chairman Henry Waxman, urging Congress to find ways to pay for comprehensive health care reforms beyond the Medicare savings already announced that will improve the program’s efficiency. In a letter to Chairman Waxman, Rand applauded the committee’s reported compromise agreement for “hold[ing] the line on additional Medicare savings.” Rand emphasized that AARP members would not support legislation that finances reform through higher out-of-pocket costs or reduced benefits for people in Medicare.

“AARP cannot support any efforts to target Medicare beneficiaries for increased cost-sharing or other benefit cuts,” Rand wrote. “In addition, we cannot support backdoor attempts to finance health care reform through increases in beneficiary costs or reductions in benefits, for example, through use of commissions or other process mechanisms.”

Rand noted that people in Medicare today already spend, on average, nearly 30 percent of their income on out-of-pocket health care costs, restating the Association’s fight against proposals that would unfairly burden people in Medicare.

Rand added: “We know you share the position, expressed by the President in his July 22 press conference—and reiterated this week in AARP’s own tele-town hall—that health reform will not result in less generous Medicare benefits.”

AARP has reassured its members that proposals it has reviewed so far to save money in Medicare will not raise their out-of-pocket costs or reduce access to care. AARP has urged Congress to find smart Medicare savings, such as reducing payments to private insurers in Medicare, lowering drug costs and preventing avoidable hospital readmissions.

In the letter, Rand applauded the Energy and Commerce Committee’s compromise agreement, which reportedly retains many of the key priorities of AARP’s members, including closing the Part D doughnut hole, strictly limiting age-rating and creating subsidies to help more Americans purchase their choice of coverage.

“We are pleased the House bill retains a stricter 2 to 1 limit on how much more insurers can charge older Americans for premiums,” Rand wrote. “In addition, we are pleased that the House Energy and Commerce bill still provides sliding-scale subsidies up to 400 percent of the federal poverty level. These subsidies are essential to making certain our members can afford coverage and not pay an unfair percentage of their incomes for health care expenses.”

For more information about AARP’s Health Action Now campaign, please visit www.healthactionnow.org.

AARP is a nonprofit, nonpartisan membership organization that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, the definitive voice for 50+ Americans and the world's largest-circulation magazine with over 35.5 million readers; AARP Bulletin, the go-to news source for AARP's 40 million members and Americans 50+; AARP Segunda Juventud, the only bilingual U.S. publication dedicated exclusively to the 50+ Hispanic community; and our website, AARP.org. AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. We have staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.

Swine Flu and Client Communication

Brookside Clinical Laboratory, Inc. has been in contact with the Department of Health in Pennsylvania, New Jersey and Delaware.

The CDC and the Department of Health from PA, NJ and DE are in consensus that the criteria for suspecting a case of the swine influenza are the following:

• Live in an area where human cases of swine influenza A (H1N1) have been identified or;

• Have traveled to an area where human cases of swine influenza A (H1N1) have been identified; or

• Have been in contact with ill persons from these areas in the seven days prior to their illness onset.

Influenza will NOT be presumed to be swine influenza or forwarded to the Department of Health in PA, NJ or DE or the CDC for confirmation unless the above three criteria are met.

Thank You.

Brookside is now offering a new HIV test.

Brookside will now perform HIV1 and HIV2 differentiating test. These tests will be available Monday thru Friday with same day results.

For Details, Contact:
Susan Simpson
Lab Operations Manager
610-872-6466

Changes to Blood Monitoring Rules for Medicare Beneficiaries

Contained within the 2007 Medicare Physician Fee Schedule is a provision to order and certify the medical necessity of each “finger stick” blood glucose test for Medicare beneficiaries beginning January 2007. This is an important edit for Skilled Nursing Facilities (SNF) in that every finger stick on a Medicare beneficiary residing in a SNF must be ordered and certified by the physician.

The edit states the following:

• SNF may bill for glucose laboratory tests (finger-stick method) when the following conditions are met:
• The test is ordered by a physician.
• The result is promptly reported to the ordering physician.
• The ordering physician uses the result in the management of the beneficiary’s specific medical needs (continuation or modification of patient care).
• If repeat testing is performed, a specific diagnosis code should be reported to support medical necessity.

Repeat performance of finger-stick blood glucose tests to maintain standing orders for insulin injections does not meet the criteria listed above. The SNF may not bill for repeated laboratory services unless there is physician involvement based on the results of the individual test.

National Independent Laboratory Association: Setting the Context

The "Medicare Prescription Drug, Improvement and Modernization Act of 2003" ("MMA") requires the Secretary of the Department of Health and Human Services ("HHS") to conduct a demonstration project on the use of competitive bidding for clinical laboratory services. As outlined in the MMA, the demonstration project will operate in two separete metropolitan statistical areas ("MSAs"), with the first scheduled to begin by April 1, 2007, and the second to begin by April 1, 2008.

QuantiFERON^®-TB Gold Test --- Fact sheet

What is it?

The QuantiFERON^®-TB Gold test (QFT-G) is a whole-blood test for use as an aid in diagnosing Mycobacterium tuberculosis infection, including latent tuberculosis infection (LTBI) and tuberculosis (TB) disease. This test was approved by the U.S. Food and Drug Administration (FDA) in 2005.

How does it work?

Blood samples are mixed with antigens (substances that can produce an immune response) and controls. For QFT-G, the antigens include mixtures of synthetic peptides representing two M. tuberculosis proteins, ESAT-6 and CFP-10. After incubation of the blood with antigens for 16 to 24 hours, the amount of interferon-gamma (IFN-gamma) is measured.

If the patient is infected with M. tuberculosis, their white blood cells will release IFN-gamma in response to contact with the TB antigens. The QFT-G results are based on the amount of IFN-gamma that is released in response to the antigens.

Clinical evaluation and additional tests (such as a chest radiograph, sputum smear, and culture) are needed to confirm the diagnosis of LTBI or TB disease.

What are the advantages?

• Requires a single patient visit to draw a blood sample.
• Results can be available within 24 hours.
• Does not boost responses measured by subsequent tests, which can happen with tuberculin skin tests (TST).
• Is not subject to reader bias that can occur with TST.
• Is not affected by prior BCG (bacille Calmette-Guérin) vaccination.

• Blood samples must be processed within 12 hours after collection while white blood cells are still viable.
• There are limited data on the use of QFT-G in children younger than 17 years of age, among persons recently exposed to M. tuberculosis, and in immunocompromised persons (e.g., impaired immune function caused by HIV infection or acquired immunodeficiency syndrome [AIDS], current treatment with immunosuppressive drugs, selected hematological disorders, specific malignancies, diabetes, silicosis, and chronic renal failure).
• Errors in collecting or transporting blood specimens or in running and interpreting the assay can decrease the accuracy of QFT-G.
• Limited data on the use of QFT-G to determine who is at risk for developing TB disease.

QFT-G can be used in all circumstances in which the tuberculin skin test (TST) is currently used, including contact investigations, evaluation of recent immigrants who have had BCG vaccination, and TB screening of health care workers and others undergoing serial evaluation for M. tuberculosis. However, caution should be used when testing certain populations because of limited data in the use of QFT-G.

Before the QFT-G is conducted, arrangements should be made with a qualified laboratory and courier service, if needed, to ensure prompt and proper processing of blood.

What are the steps in administering the test?

• Confirm arrangements for testing in a qualified laboratory and arrange for delivery of the blood sample in time for the laboratory to initiate testing within 12 hours of blood collection.
• Draw a sample of whole blood from patient into a tube with heparin anti-clotting agent, according to manufacturer’s instructions.
• Schedule an appointment for the patient to receive test results and, if then needed, medical evaluation and possible treatment for TB disease or LTBI.

Interpretation of QFT-G results is based on IFN-gamma concentrations in test samples. Each QFT-G result and its interpretation should be considered in conjunction with other epidemiological, historical, physical, and diagnostic findings.

A positive result suggests that M. tuberculosis infection is likely; a negative result suggests that infection is unlikely; and indeterminate result suggests QFT-G results cannot be interpreted as a result of low mitogen response or high background response.

A diagnosis of LTBI requires that TB disease be excluded by medical evaluation, which should include checking for signs and symptoms suggestive of TB disease, a chest radiograph, and, when indicated, examination of sputum or other clinical samples for the presence of M. tuberculosis.

Additional Information

Centers for Disease Control and Prevention. Guidelines for the investigation of contacts of persons with infectious tuberculosis and Guidelines for using the QuantiFERON^®-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. MMWR
2005; 54 (No. RR-15).
http://www.cdc.gov/mmwr/pdf/rr/rr5415.pdf (PDF)

Centers for Disease Control and Prevention. Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005. MMWR 2005; 54 (No.RR-17).
http://www.cdc.gov/mmwr/pdf/rr/rr5415.pdf (PDF)

Providing you Infection Prevention and Control Support.

Brookside Clinical Laboratory has, on staff, a Certified Infection Control Practitioner with a total of 30 years experience in Long Term and Acute Care. Our ICP can provide a complete on site Infection Prevention Program or tailor one to meet your Facility's individual needs including:

Surveillance Activities:

• Definitions of nosocomial infections which will provide early, uniform identification and reporting
• A system for reporting, evaluating, and maintaining records of infections among residents and staff.
• Prospectively nosocomial infection data via Medication Kardex review, nursing documentation and laboratory reports or
• Tutor staff to accomplish surveillance activities
• Review and evaluation of antibiotic usage
• Formal monthly reports of nosocomial infections
• Assist in evaluating unusual infections or outbreak situations
• Reports for the investigations to appropriate agencies
• Periodic Unit rounds with findings and recommendations
  
  

Policies and Procedures:

• Write a facility specific infection control policy manual
• Review all existing infection control policies yearly with revision as needed.
• Review, evaluation and tailor policies on all aseptic, isolation, and medical waste management issues
• Employee Health Program OSHA Blood-borne pathogens and Tb requirements
• Participate in the orientation program for all new employees
• Annual programs for all departments including OSHA blood-borne pathogen Standard and Tuberculosis Prevention and Control
• A full range of infection control topics
  
  

MEDICARE Modernization Act:

On December 8, 2004 George W. Bush signed into law the Medicare Prescription Drug, Improvement and Modernization Act (MMA) . The provisions in the MMA allow for preventative and screening tests for Cardiovascular Disease and Diabetes. These new screening tests the MMA allows are in addition to other screening tests for PSA, Colorectal Cancer and Pap Smears.

Effective January 1, 2005 screening tests for Cardiovascular Disease will be permitted under the following conditions:

MMA will provide Medicare coverage of cardiovascular screening blood tests, including tests for cholesterol, high density lipoprotein and triglycerides. Beneficiaries will be allowed to be screened every five years.

Effective January 1, 2005 screening tests for Diabetes will be permitted under the following conditions:

MMA will provide Medicare coverage of diabetes screening blood tests including a fasting plasma glucose test and post-glucose challenges. Beneficiaries will be allowed to be screened up to twice a year.

If you choose to use these new screening benefits for your patients, please indicate “screening” as the diagnosis when you complete the lab requisition.

Brookside Clinical Lab NOW OFFERS:

INFLUENZA A AND B TESTING

In order to better service you and your residents this flu season, Brookside Clinical Laboratory, Inc. is offering Influenza A and B testing with twenty-four hour turnaround time, Monday through Friday.

Test will be performed from October 10, 2004 until April 10, 2005.

Please call our Microbiology Department for nasal transport, swabs and instructions.

News Release: Health Insurance Portability and Accountability Act of 1996 (HIPAA) Information

Like many of you, Brookside is working diligently to accommodate the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Since our goal is to provide the highest level of service possible, we wanted to make certain that you understand the HIPAA requirements and how to comply with the directives.

HIPAA Law

An Act:
To amend the Internal Revenue Code of 1986 to improve portability and continuity of health insurance coverage in the group and individual markets...

4/11/03 Guidance on Privacy and Public Health

New national health information privacy standards have been issued by the U.S. Department of Health and Human Services (DHHS), pursuant to...

Legislative News

CLINICAL LABORATORY COALITION

Committed to Ensuring Access to Quality Laboratory Services

September 3, 2004
Mark B. McClellan,M.D., Ph.D.
Administrator
Centers for Medicare and Medicaid Services

Hubert H. Humphrey Building
200 Independence Avenue, SW
Washington , DC 20201

Dear Dr. McClellan:

The Clinical Laboratory Coalition ("CLC"), a coalition of organizations representing the many sectors of the clinical laboratory industry, seeks to work closely with the Centers for Medicare and Medicaid Services ("CMS") as CMS, and the contractor selected by CMS, proceed to implement competitive bidding for clinical laboratory services pursuant to section 302 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 ("MMA").

This letter is intended to amplify the concerns expressed by several members of the CLC at the March 2004 Open Door Forum and to indicate our interest in working with CMS as the competitive bidding demonstration project moves forward. We are very concerned about conclusions that could be reached based solely on reductions in Medicare reimbursement if correspondingly this causes significant adverse effects to patients and health care providers, or to the clinical laboratory industry. We have outlined below some of our collective concerns and believe that the active involvement of the clinical laboratory industry will ensure that the competitive bidding demonstration implementation is fair and that the results and conclusions derived from the demonstration project are fully reflective of all of the information generated from the demonstration.

Technical Experts Panel

We request that CMS work closely with the clinical laboratory industry in the selection of the members of the Technical Experts Panel ("TEP") and the frequency of TEP meetings. To ensure that the input of all affected parties is received and considered, CMS and the contractor implementing competitive bidding should receive nominations for the TEP - and appoint - from the full spectrum of clinical laboratory industry and professional organizations and their individual members that are impacted by the demonstration project so that all organizations and perspectives are represented on the TEP. Moreover, the TEP should meet at least (or at a minimum) at the following decision points in the demonstration project:

• Prior to the request for clinical laboratory service providers to submit bids to participate in the bid design and avoid unintended problems as a result of an ill-conceived request for bids;
• Prior to the selection of the demonstration area to ensure that the area is representative of the clinical laboratory industry;
• Prior to initiation of the demonstration project to evaluate the quality and access indicators and to ensure that accurate information regarding current clinical laboratory service providers and service characteristics are captured in the demonstration areas so that any impact or effect from the implementation of competitive bidding can be measured;
• At the implementation phase so that all parties can ask questions and understand how the contractor will implement the demonstration project;
• At the mid-point of the demonstration project to reassess the quality and access indicators so that any impact or effect from the implementation of competitive bidding can be identified and corrected to avoid any unintended consequences that could be very devastating to patients, health care providers or clinical laboratory service providers; and,
• At the end of the demonstration project so that the information developed during the demonstration project can be digested and analyzed prior to the preparation of a report to CMS.

Open Door Forums

We request that input from the clinical laboratory industry be solicited vis-à-vis regular Open Door Forums ("ODF"). The ODF could serve as an important interactive and regular communications vehicle for the clinical laboratory industry and individual providers to respond to the billing and reimbursement issues that would impact the industry as a result of competitive bidding. Moreover, it would keep the industry apprised of the implementation of competitive bidding and the information generated as a result of competitively bidding clinical laboratory services. Given the potential impact of competitive bidding on the entire clinical laboratory industry, CMS should hold ODFs at each of the decision-points identified above for the TEPs to facilitate interactive and regular communication with the entire clinical laboratory industry and to receive input.

Comprehensive Demonstration Project

To provide an accurate assessment of competitive bidding, we also urge CMS to establish a comprehensive demonstration project. Entities bidding in the demonstration area(s) should be required to bid on all clinical laboratory tests available on the Medicare test menu and ensure all Medicare beneficiaries in the demonstration area have access to those tests. By doing so, CMS will receive bids that more closely reflect what is necessary to fully deliver clinical laboratory services in a geographical area.

We thank you for your attention to these concerns and look forward to these issues being addressed as part of the competitive bidding demonstration project for clinical laboratory services. Please know that we stand by ready to work with you, your colleagues, the chosen contractor, Members of Congress, and other stakeholders to ensure that the results of thia, demonstration project are as sound and definitive as possible.

Sincerely,

American Association of Bioanalysts
American Association for Clinical Chemistry
American Clinical Laboratory Association
American Medical Technologists
American Society for Clinical Laboratory Science
American Society for Clinical Pathology
American Society for Microbiology
Clinical Laboratory Management Association
College of American Pathologists

*Sectors of the clinical laboratory industry include, but are not limited to : national, publicly traded independent clinical laboratories; regional, multi-state independent community laboratories; community laboratories; large urban hospital laboratories (outpatient and non patient); small and rural hospital clinical laboratories (outpatient and non patient); physician office laboratories (ranging in size from one physician to hundreds and even thousands of physicians); ambulatory surgery center laboratories; community clinic laboratories; end stage renal disease dialysis facilities; home health agency laboratories; hospice laboratories; insurance testing laboratories; pharmacies; intermediate care facilities for the mentally retarded; industrial laboratories; school/student health service laboratories; skilled nursing facilities laboratories; blood banks; tissue banks; rural health clinic laboratories; other health care practitioner offices (e.g., dentists, nurse midwifes, nurse practitioners, physician assistants, etc.); ambulance service laboratories; HMO laboratories; mobile laboratories; and federally qualified heath center laboratories.

Congress thinks seniors can afford to pay $18 billion more just to keep their current Medicare benefits...

THINK AGAIN

CALL NOW BEFORE IT IS TOO LATE!

OPPOSE THE HIDDEN MEDICARE TAX ON SENIORS IN CONFERENCE

The Senate has hidden a provision in the Prescription Drug Bill that eliminates the federal commitment to pay 100% of the cost of essential laboratory tests for seniors.

If this provision remains in the bill, seniors will have to pay nearly $20 billion in new out-of-pocket costs just to keep their existing Medicare benefits.

Seniors, health care costs are already soaring, why would Congress want to penalize older Americans and discourage them from getting the medical tests ordered by their doctors?

Oppose the hidden Medicare tax on seniors.

Because seniors can't afford to miss life-saving medical tests and they can't afford to foot the bill.

Oppose Section 431 of the Senate Version

WHAT CAN YOU DO?

CALL THE SENATE-HOUSE LEADERSHIP AND TELL TEHM

"NO 20% CO-PAYMENTS FOR LAB TESTS"

These Legislators Will Be Deciding If Seniors Will Have To Pay 20% Co-Payments

Senators

Sen. Chuck Grassley (R-IA)

Washington  (202)224-3744

District Office (319)363-6832

Sen. Orin Hatch (R-UT)

Washington  (202)224-5754

District Office (801)524-4380

Sen. Don Nickles (R-OK)

Washington  (202)224-5754

District Office (405)231-4941

Sen. Bill Frist (R-TN)

Washington  (202)224-3344

District Office (423)756-2757

Sen. Jon Kyl (R-AZ)

Washington  (202)224-4521

District Office (602)840-1891

Sen. Max Baucus (D-MT)

Washington  (202)224-2651

District Office (406)657-6790

Sen. John Rockefeller (D-WV)

Charleston  (304)347-5372

District Office (304)253-9704

Sen. Thomas Daschle (D-SD)

Washington  1-800-424-9094

(toll-free from S. Dakota) or (202)224-2321

District Office (605)334-9596

Sen. John Breaux (D-LA)

Washington  (202)224-4623

District Office (225)248-0104

House Members

Rep. Billy Tauzin (R-LA)

Washington  (202)225-4031

District Office (985)876-3033

Rep. William Thomas (R-CA)

Washington  (202)225-2015

District Office (661)327-3611

Rep Michael Bilirakis (R-FL)

Washington  (202)225-5755

District Office (727)773-2871

Rep Nancy L. Johnson (R-CT)

Washington  (202)225-4476

District Office (860)223-8412

Rep. Tom DeLay (R-TX)

Washington  (202)225-5951

District Office (281)240-3700

Rep. John Dingell (D-MI)

Washington  (202)225-4071

District Office (313)278-2936

Rep. Charles Rangel (D-NY)

Washington  (202)225-4365

District Office (212)663-3900

Rep. Marion Berry (D-AK)

Washington  (202)225-4076

District Office (870-972-4600