June 2008
Before the Clinical Laboratory Improvement Amendments of 1988 (CLIA) took effect in 1992, significant numbers of primary care physician office laboratories (POLs) performed tests that are now classified as moderate and high complexity. At that time, no quality requirements existed for POLs and reimbursement for lab tests was generous in comparison to today, since managed care was virtually nonexistent and Medicare fee cuts and freezes had not yet begun.
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