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  Health Care Coverage and Financing

 

Policy Synopsis

The College supports these goals with regard to health care coverage and financing:

  • pathologist participation in determining health plan benefits pertaining to utilization;
  • universal access to health care;
  • non-discriminatory determination of insurance coverage; and
  • standardized nomenclature for computerized patient records.

Policy

Pathologists must be involved in the determination of the scope of health plan benefits pertaining to utilization of clinical and anatomic pathology services. Adequate resources must be allocated for the provision of laboratory direction, quality assurance, and other services provided by laboratory directors.

The College supports universal access to basic health care.

The College of American Pathologists supports the establishment of, and would assist in the development of, a public/private partnership that includes the physician community in formulating policy and implementing activities in areas of health policy, particularly in areas of technology use and dispersion, quality assurance, medical education, and fiscal issues.

The College supports insurance reform including rating and underwriting practices that would ensure a non-discriminatory determination of health insurance premiums and coverage. Portability of health insurance is important to continued coverage.

The College recognizes the need for a national provider identifier (NPI) as a means to eliminate multiple numbers currently used by physicians for administrative and financial purposes. The College is concerned about the misuse of information under an NPI system and opposes public access to such information. Data collected as a part of an NPI should be kept to an absolute minimum. Therefore, data not required for enumeration, administrative or financial purposes should not be collected. NPI enumeration should be done by one entity at no cost to individual physicians.

The College recommends that, as attention in the health care industry focuses on adoption of coding systems for the complete computer-based patient record, the federal government take steps toward adopting a standard controlled reference terminology such as the Systematized Nomenclature of Human and Veterinary Medicine (SNOMEDÆ). A controlled reference terminology that enhances interpretability and comparability is necessary to document patient care, retrieve health data to perform studies and assess patient outcomes.

Revision History

Adopted August 1995
Reaffirmed August 1998
Revised November 1998
Reaffirmed February 2002
Revised April 2008
Revised December 2013