The California Clinical Laboratory Association (CCLA) was formed in November 1976 by a group of people representing both small and large laboratories. The founders felt that the California lab community needed to have its own program and voice. They created an active organization designed to deal with State regulations and legislation and to supplement the activities of the American Clinical Laboratory Association on Federal issues. The organization has grown to become instrumental in the formation and enactment of State and Federal laboratory legislation. Its activities include monthly business meetings and an annual meeting held in November of each year.
- Medi-Cal Provider Rates - Protecting and increasing Medi-Cal provider rates has been a main focus of CCLA through the years. In 1984, CCLA was successful in securing the reinstatement of the 25% Medi-Cal cuts of 1982. In 1987 and 1988 CCLA stopped efforts to reduce reimbursement rates for clinical laboratory services provided under the Medi-Cal program. In the 1990's CCLA continued its efforts to successfully protect reimbursement rates. During 2003, laboratory services were exempted from the 5% provider rate cut adopted as part of the budget. The Legislature adopted language calling for a cap on laboratory reimbursement rates at 80% of Medicare rate. At that time CCLA also began working with DHS to improve workability of the newly implemented frequency limits. In 2004 CCLA fought against the Medi-Cal contracting program. This program was ultimately dropped by DHS. During 2007-2008 CCLA continued to work against proposed rate cuts and the federal contracting program. CCLA worked hard to restore the 10% rate cut which took effect on July 1, 2008 and to avoid further cuts in this important program. As of March 1, 2009, the rate cut was reduced to 1%. In 2011, AB 97 passed the Legislature and was signed by the Governor as Chapter 3, Statues 2011. AB 97 imposed a Medi-Cal payment cut by imposing a ten percent payment reduction -- retroactive to June 1, 2011. In 2012, AB 1494 was passed the Legislature and was signed by the Governor as Chapter 28, Statues of 2012. AB 1494 imposes an additional ten percent payment reduction for Medi-Cal clinical laboratory services. The retroactive start date for the additional ten percent payment reduction is July 1, 2012. This bill also requires the Department of Health Care Services (DHCS) to devise a new rate development methodology for the reimbursement of clinical laboratory services. DHCS has collected considerable data from clinical laboratories as part of this effort, but their progress has been slow and no stakeholder meetings have been scheduled for the past several months. AB 1494 called for DHCS to adopt new regulations implementing the new rate methodology by July 1, 2014. However, AB 1124, Chapter 8, Statutes of 2014, extended that deadline until June 30, 2016. DHCS has not yet implemented the cut called for by AB 1494 due to questions from CMS.
- Medi-Cal Carrier Advisory Committee - In 2007, members of CCLA formed a Medi-Cal Carrier Advisory Committee. This group consists of members of CCLA who come to Sacramento once every three months to meet with staff at the Department of Health Care Services to discuss issues relating to the Med-Cal program. Several issues have been resolved through this dialogue, such as the following: more than $1.9 million in vitamin B-12 reimbursement for clinical labs; frequency limit modification for ESRD patients; review of the reservation system; reprocessing of services that were denied utilizing unpublished diagnosis edits prior to the publication of the respective policies such as Ferritin, Papilomavirous, FSH, and LH (recovery valued at $2 million); fix of the FPACT enrollment gender default problem; and many others. To date, the activities of this CCLA committee have resulted in recovery of more than $5 million in previously denied claims for California laboratories.
- Legislation and Regulations - Throughout the years, CCLA successfully stopped many bad bills and has helped enact important new laboratory laws. Some issues which CCLA was instrumental in stopping were mandatory reporting of cholinesterase testing, strict reporting mandates regarding childhood lead screening, additional reporting requirements for other testing without additional reimbursement, and proposals to allow pharmacists to serve as lab directors. Important issues which CCLA sponsored and help enact related to the following: the law prohibiting physicians from "marking up" the cost of laboratory testing; new licensure laws for clinical laboratory scientists; the new law creating the Medical Laboratory Technician (MLT) Licensure program; new laws relating to the workload of cytotechnologists; standards for health fair testing; electronic reporting; and laws to permit direct access testing.
- To actively participate in the public policymaking process and ensure the governmental reimbursement rates for clinical laboratory services will allow full participation by laboratories and adequate access to services for Medicare and Medi-Cal patients.
- To encourage the enactment of uniform laboratory legislation and administrative regulations for the protection of the public.
- To encourage the enactment of non-restrictive legislation, regulation and policies so as to permit the free flow of commerce, and to assure laboratory operations which best serve the interests of the public.
- To encourage the exchange of certain statistical and administrative data relating to the operation of clinical laboratories.
- To cooperate with governmental authorities, professional associations and other interested parties in the health field, in order to provide better health care to the public.
- To foster high standards and to promote generally the welfare of California licensed clinical laboratories.
- To encourage and promote greater efficiency, reliability and safety in the performance of clinical laboratory testing, and improve the service provided by clinical laboratories to research organizations, physicians, governmental associations and the general public.