College of American Pathologists
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CAP Today




April 2008
Feature Story

House to vote on cytology billHouse to vote on cytology bill

The Cytology Proficiency Improvement Act of 2007 was referred to the floor of the U.S. House of Representatives March 13 after a unanimous vote of approval in the Energy and Commerce Committee.

H.R. 1237—introduced by Reps. Bart Gordon (D-Tenn.), Tom Price (R-Ga.), and Nathan Deal (R-Ga.) and supported by 175 House cosponsors—would replace the current cytology proficiency testing program with a less punitive approach that requires annual continuing medical education requirements to enhance locator and interpretive skills.

The CAP has waged an intense campaign of support for H.R. 1237 as part of the Proficiency Improvement Coalition, a group of more than 60 organizations. This collective advocacy effort will seek to build support for S. 2510, the Senate companion measure, introduced Dec. 18 by Sens. Mary Landrieu (D-La.) and Johnny Isakson (R-Ga.).

Defeating licensure legislation Defeating licensure legislation

State licensure bills in Minnesota and Massachusetts were defeated recently, and similar legislation in Alaska and Missouri faces CAP and state pathology society opposition.

The Massachusetts State House rejected H. 2228 March 18, while in Minnesota S.F. 1830 and companion bill H.F. 2109 were shelved with no vote.

The CAP campaign to defeat state licensure laws continues against S.B. 1162 in the Missouri Senate and S.B. 295 and companion bill H.B. 339 in Alaska.

The Missouri Society of Pathologists joined the CAP in a letter of opposition to S.B. 295. That was followed by state pathology society testimony at a March 31 hearing.

In addition, the St. Louis Society of Cytology urged lawmakers in a letter to reject the bill, saying “the vast majority of laboratorians, including Clinical Laboratory Scientists, are not in favor of this legislation.”

“We believe that patients in Missouri are best served by allowing laboratories, hospitals, and physicians the ability to determine who performs the appropriate testing,” the letter said.

In Alaska, lawmakers held a hearing April 1 on S.B. 295 in the Senate Commerce and Labor Committee. The bill was met with a joint letter of opposition from the CAP and the newly established Alaska Pathology Society.

In the letter, the Alaska society and the CAP note “the detrimental quality impact that licensure has had on New York State, which in 2005 became the only state to have enacted such a law in the 15 years since federal standards for clinical laboratories were promulgated.”

Under CLIA, laboratory directors and pathologists are granted the authority to select, assign, and qualify individuals as part of their direction of the clinical laboratory. It is the CAP’s position that licensure laws limit that authority and complicate administration of the clinical lab.

The College argues that licensure require­ments would unduly restrict the discretion of the laboratory director, most frequently a pathologist, to qualify, assign, and direct personnel in the laboratory.

The CAP points out that most existing state licensure laws for laboratory personnel preceded the 1992 regulatory enactment of CLIA, which provides appropriate quality requirements for clinical labs.

Blocking physician payment cutsBlocking physician payment cuts

The Save Medicare Act of 2008 was introduced in the U.S. Senate March 13 with the aim of canceling the scheduled 10.6 percent Medicare payment cut for physicians set for July 1 and replacing it with an 18-month pay hike.

S. 2785, introduced by Sen. Debbie Stabenow (D-Mich.), would replace the scheduled cut with a 0.5 percent pay hike for the remainder of 2008 and include as much as a 1.8 percent pay raise in 2009.

This action follows the recent introduction of H.R. 5445 by Reps. Tom Price (R-Ga.) and David Scott (D-Ga.), legislation that would delay pending cuts to Medicare payments to physicians for 18 months, from July 1, 2008 through Dec. 31, 2009, to give Cong­ress adequate time to find an appropriate long-term solution to the Medicare reimbursement problem.

H.R. 5445 was referred Feb. 14 to the House Energy and Commerce subcommittee on health and had 28 cosponsors as of March 20.

Justin Herman is CAP manager, Communications for Advocacy, Washington, DC.