Clinical labs seek support to strengthen Puerto Rico’s voice in Washington
By THE STAR STAFF
The Puerto Rico Clinical Laboratories Association (ALCPR) is moving to elevate the island’s presence in federal health‑policy debates, announcing its affiliation with the American Clinical Laboratory Association (ACLA) as part of a broader push to safeguard Medicaid funding and secure long‑term reforms to laboratory reimbursement systems.
The partnership aims to add ACLA’s national advocacy power to Puerto Rico’s effort to obtain a permanent fix to the island’s Medicaid financing formula, which faces a steep drop in federal support in 2027. At the same time, ALCPR will join ACLA in urging Congress to approve the bipartisan RESULTS Act, legislation that would overhaul how Medicare sets reimbursement rates for laboratory tests.
The measure would replace the current data‑reporting system under the Protecting Access to Medicare Act (PAMA) with a new database built from private‑insurance claims. Supporters say the change is needed to prevent further cuts to Medicare reimbursement rates and protect patient access to essential diagnostic testing.
“This affiliation gives Puerto Rico a seat at the table where decisions are made about whether our laboratories can continue serving patients,” said ALCPR president Felipe Cintrón. “We will now have direct access to the data and officials needed to defend a fair reimbursement system that preserves access to health services.”
Cintrón noted that the same structural issues destabilizing laboratory payments nationwide — rates disconnected from real costs and market data — have driven significant cuts in Puerto Rico. An economic study commissioned by ALCPR in 2023 found that Medicare Advantage laboratory rates on the island fell nearly 30 percent between 2012 and 2022, even as insurance premiums rose more than 40 percent. Local insurers have since imposed additional reductions, particularly in the Medicare Advantage and Plan Vital segments.
ALCPR leadership is in Washington this week for congressional meetings. The group has already met with staff from both the majority and minority of the Senate Finance Committee and the House Ways and Means Committee, with ACLA — including a meeting with its president, Susan Van Meter — and with the Puerto Rico Federal Affairs Administration (PRFAA).
Discussions with congressional staff focused on Medicare and Medicaid policy, reimbursement methodologies, federal health‑care funding, and the importance of Puerto Rico maintaining an active role in shaping national health legislation.
“These steps represent the beginning of our commitment to this effort,” Cintrón said. “We will work alongside ACLA and our allies in Washington until Congress acts to protect Puerto Rico’s federal matching rate. What’s at stake, beyond a funding formula, is access to essential diagnostic services for thousands of our patients.”
Absent congressional action, Puerto Rico’s temporary enhanced Medicaid Federal Medical Assistance Percentage (FMAP) — currently 76 percent — will expire in September 2027, dropping the island back to a 55 percent match and significantly increasing the financial burden on the local government.
ACLA, founded in 1971 and based in Washington, D.C., represents major U.S. clinical laboratories before Congress, federal regulators, and the public.
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