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Can Blood Tests Be Negotiated by Professional Lab Organizations?

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Published on May 11, 2017

Patient Power Host Dr. Susan Leclair answers the question: Do any of the professional organizations have an impact on the cost of blood test procedures? In the video, she addresses this question by explaining how organizations are working on handling reimbursements to help make them more rational. Dr. Leclair is a Patient Power host and retired chancellor professor from the Department of Medical Laboratory Science at the University of Massachusetts, Dartmouth.

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Transcript |

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Question:

As a laboratory scientist, do any of the professional organizations have an impact on the cost of blood test procedures?

Dr. Leclair:

Not as much as we would like is the short answer. The long answer is that there are process within the federal government that allow you to work with the Medicare and Medicaid bureaus to develop reimbursement issues. Because Medicare is so influential, they service the base for most insurance companies. So if you can do something with Medicare, then you probably got you probably got yourself a pretty good base to handle reimbursement with the other national but still smaller than Medicare insurances. There’s a process called negotiative rule making. It’s a hideous process to go through. Everybody who is concerned with a particular topic is essentially locked in a room, and they don’t come out until they come to a decision on how much a blood glucose might be reimbursement. It’s a hard process. It’s a long process. It’s a pretty fair process as you move along.

My professional organization, the American Society for the Clinical Laboratory Science, and a lot of the other ones, have been arguing, begging, pleading with the the federal House of Representatives and Senators to authorize a negotiate rule making, because we have not had a really thorough look at the costs of clinical laboratory tests since the mid-1980s., That means that whatever cost was back then - the agreed-upon cost - let’s say a blood glucose - is the same cost that we’re charging today. And as we all know, blood glucose has changed considerably. You’ve got the home testing, you’ve got whether or not you’re using finger stake or all the rest of that stuff. So that’s really gonna change. The other issue is there’s been no discussion about how to handle reimbursement for genetic testing, because in the 1980s that didn’t happen. So the long answer is yes, we’ve been trying to get a process together whereby we can look at reimbursement and make it more rational . The short answer is we’ve not been able to make much progress on that.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.