TMA Calls On Feds to Protect Medicaid Patients’ Access to Tests
By David Doolittle

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The Texas Medical Association continues to push back against the rollout of the Protecting Access to Medicare Act (PAMA), which could cause Medicaid patients in Texas and elsewhere to lose access to needed clinical tests.

TMA signed off on a letter to U.S. Rep. Michael Burgess, MD (R-Lewisville) asking him to take action against the federal law, which is used to set Medicare payment rates for lab tests. Representative Burgess is chairman of the House Energy and Commerce Subcommittee on Health Care. 

Specifically, PAMA directs the Centers for Medicare & Medicaid Services (CMS) to base Medicare payments for tests on the Clinical Laboratory Fee Schedule (CLFS) on rates paid by private payers. Medicare payment rates that took effect Jan. 1 were cut by as much as 10 percent – and further reductions are expected in 2019 and 2020, according to a letter TMA and other medical organizations sent to CMS Administrator Seema Verma in May.

In Texas, Medicaid payments for clinical laboratory services cannot exceed Medicare rates, so any decrease in the Medicare allowable could translate into Medicaid cuts, too. Further reductions could cause many seniors and other vulnerable patients to lose access to services such as lab tests.

We can’t allow unelected federal bureaucrats to undermine a vital benefit promised to seniors and members of the disability community as part of Medicare,” the letter to Representative Burgess says. “We urge you to stand up for this vulnerable population in Texas and across the country and protect them from these harmful and ill-conceived cuts to vital laboratory services.”

Several other organizations and medical societies signed on to the letter, including the Coalition of Texans with Disabilities, Easterseals North Texas, and the Texas Kidney Foundation.

Texas Medicine has reached out to Representative Burgess’ office for his reaction and will update this story with his response.


Last Updated On

August 03, 2018

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David Doolittle


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Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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