ing policy and making decisions about fees and clearer communications for presenting them. Changes are also needed in administrative procedures, particularly for the incorporation of new tests, to streamline procedures and make them more efficient. The committee was concerned with the lack of data on which to base a judgment of whether HCFA’s fees for individual services were set at an appropriate level and the lack of data on the frequency of inappropriate use.

The committee believes that the shortcomings discussed in this chapter can and should be addressed. Time tends to exacerbate such problems because laboratory practice and the larger health care system continue to change, thus putting further stress on an already cumbersome and inefficient system. By taking action promptly, HCFA and the Congress can revise the payment system to better accommodate the technological advances expected in the decades ahead. In the next chapter the committee discusses alternatives for change. In Chapter 7 the committee presents its recommendations for changes in payment methodology.

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