College of American Pathologists
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  STATLINE — CAP’s Bi–Weekly Federal and
  State Advocacy E–Newsletter

April 2, 2009  •  Volume 25, Number 7
Next Issue: April 16, 2009
© 2009 College of American Pathologists

In This Issue:

White House Proposed Federal Budget Expected to Pass House and Senate With
Healthcare Provisions

Comparative Effectiveness Research Initiatives In Stimulus Package Take Shape
Medical Home a Top Issue on State Society Presidents’ Quarterly Conference Call
Cytology PT, CER and Budget Issues Discussed on CAP-led National Pathology Org Conference Call
Sebelius Confirmation Hearings for Secretary of HHS Begins
CAP Advocacy School Hits Record High for New Registrants

White House Proposed Federal Budget Expected to Pass House and Senate With Healthcare Provisions

The Federal Budget for 2010 proposed by the White House is expected to pass the House and Senate today if brought to the floor to vote despite continued debate over high-cost provisions that include sweeping investments in healthcare reform initiatives.

The budget sets aside a reserve fund of more than $630 billion over ten years to finance healthcare initiatives including reform of the physician pay system—opening the door to revising the sustainable growth rate formula—and the adoption of Health Information Technology.

The White House estimates that repealing the SGR formula instead of revising it would cost $330 billion over the next decade. Sen. Max Baucus (D-MT), chair of the Senate Finance Committee, has stated however that revising Medicare physician payment is a top priority, and is working with the White House and other lawmakers on payment reforms that could help reduce that cost.

Debate about the budget continued on Capitol Hill until the day of the vote, with House and Senate Republicans unveiling an alternative proposal April 1 that cut much of the healthcare reform provisions by instituting a five-year freeze on non-Defense spending.

The College will continue to monitor the progress of healthcare provisions in the proposed Federal Budget, and will report developments in future issues of Statline.

For more information on healthcare provisions in the proposed budget, view the March 5 addition of Statline.

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Comparative Effectiveness Research Initiatives In Stimulus Package Take Shape

The Department of Health and Human Services March 19 named the members of the Federal Coordinating Council for Comparative Effectiveness Research, a body created to help coordinate research and investments in comparative effectiveness research funded by the American Recovery and Reinvestment Act of 2009.

The announcement was followed by a request from the Institute of Medicine (IOM) March 24 for public input on priorities for the $400 million in CER funding provided to HHS in the economic stimulus package. IOM will submit a consensus report by June 30, 2009, that provides specific recommendations to Congress and HHS for the expenditure of these funds.

Comparative Effectiveness Research aims to compare available health care tests and treatments to determine whether there are significant advantages or disadvantages with different approaches. The results of this may help patients make better decisions about what health care they want to have, and help physicians focus on the best tests and treatments.

The 15-member federal council includes representatives from CDC; CMS; HHS; AHRQ; FDA; NIH; DOD; VA; Abuse and Mental Health Services Administration; Health Resources and Services Administration; and the Office of the National Coordinator for Health Information Technology.

IOM’s Priority Setting Advisory Committee will spend the next three months developing and implementing a priority setting process to identify a broad range of topics for consideration, including new, emerging, and well-established health services and technologies for prevention, diagnosis, and treatment.

Some members of Congress, in response to the mandate authorizing the federal council, voiced concern that it could lead to government interference in diagnosis and treatment by enforcing clinical treatment and protocols.

The council has publicly stated, however, that it will remain an advisory organization.

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Medical Home a Top Issue on State Society Presidents’ Quarterly Conference Call

CAP held the State Society Presidents’ Quarterly Conference Call March 26, with presidents from more than half the states in the US coming together to collaborate and share information on key issues for pathologists including recent developments in the Medical Home model for patient-centered care.

The call, moderated by Council on Government and Professional Affairs chair Andrew Horvath, MD, FCAP, and Richard Gomez, MD, FCAP, chair of CAP’s Federal and State Affairs Committee, covered healthcare provisions in the economic stimulus package and the President’s proposed federal budget, as well as the proposed Cytology Proficiency Testing regulation. However, medical home demonstration projects emerged as the top issue.

Congress directed the Centers for Medicaid and Medicare Services to use a three-year demonstration project to “design the health care delivery system to provide targeted, accessible, continuous and coordinated, family-centered care to high-need populations.”

Participants also discussed other Medical Home demonstration projects already in existence, including the Geisinger Medical Home, National Committee for Quality Assurance’s Physician Practice Connections-Patient Centered Medical Home (PPC®-PCMH™) and components of the Community Care for North Carolina program.

“CAP is actively monitoring advancements in medical home models in both the private sector and the Medicare demonstration under development,” said Dr. Gomez, “and in particular the involvement of pathologists and their contribution as these projects gain momentum.”

Dr. Gomez also thanked the state society presidents for contributing comments and feedback on the proposed Cytology PT regulation to the Centers for Medicaid and Medicare Services.

With the help of those contributions, the College, as well as the Cytology Proficiency Improvement Coalition, submitted comments March 17 to CMS in opposition to the proposed revisions to the regulation, as reported in Statline.

For more information on the State Society Presidents’ Quarterly Conference Call, contact State Affairs manager Mike Troubh at

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Cytology PT, CER and Budget Issues Discussed on CAP-led National Pathology Org Conference Call

The proposed Cytology Proficiency Testing regulation; developments in Competitive Effectiveness Research; and healthcare provisions in the economic stimulus and proposed federal budget were among the topics discussed during the CAP-led National Pathology Organization Conference Call March 23.

The National Pathology Organization Conference Call, moderated by CAP Council on Government and Professional Affairs chair Andrew E. Horvath, MD, FCAP, brings representatives from key pathology organizations together to share and discuss information on key legislative, policy and regulatory issues “on the front burner.”

“It is imperative for all Pathology organizations to meet and participate in addressing today’s pressing issues,” said Dr. Horvath. “We must all be involved in sharing information to ensure that the pathology community maintains a strong unified voice.”

In addition to federal issues, the efforts of State Pathology Societies to advance direct billing, anti-markup and disclosure legislation were also discussed.

National organizations on the conference call included: the American Society of Cytopathology, the Association for Molecular Pathology, the Association of Pathology Chairs, the Association of Directors of Anatomic and Surgical Pathology, the National Association of Medical Examiners, the United States and Canadian Academy of Pathology and the College.

For more information on this initiative, contact Melissa Stegun, Assistant Director of CAP Coalition Development.

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Sebelius Confirmation Hearings for Secretary of HHS Begins

Kansas Governor Katherine Sebelius pledged swift action to address the urgent need for healthcare reform at the opening of her confirmation hearings for Secretary of Health and Human Services March 31, declaring that healthcare reform is her “mission.”

Governor Sebelius’ healthcare credentials include eight years of service as the Kansas Insurance Commissioner and her role as overseer of Kansas’ Medicaid program, where she was credited with boosting health-care assistance for the poor.

During her initial confirmation hearing, Governor Sebelius reaffirmed that the White House is leaving the door open for the use of a partisan procedural tactic called “reconciliation” to move forward the healthcare reform agenda.

Reconciliation would enable the Senate to pass a healthcare bill with just 51 votes rather than the 60 normally required.

While controversial, the reconciliation tactic would allow the White House to move forward its healthcare reform agenda without bipartisan support, which may prove critical since votes fell largely down party lines for the economic stimulus package.

Though the confirmation hearing Tuesday was before the U.S. Senate Committee on Health, Education, Labor and Pensions, her nomination must be approved by the Senate Finance Committee before advancing to a full floor vote.

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CAP Advocacy School Hits Record High for New Registrants

Fifty-six first time attendees have registered for the 2009 Advocacy School in Washington, D.C., May 4 – 6, making it the largest Advocacy School class in the history of the program.

In addition to the record number of attendees, the College is flying in pathologists from around the country to participate in CAP’s national lobby day on Capitol Hill, which is held at the end of Advocacy School.

The increase in participation far surpasses the previous record of 47 attendees, and underscores the critically important role CAP members have in making sure their voices are heard at this crucial time of healthcare reform.

Attendees at Advocacy School receive in-depth political advocacy training, learn about the College’s key issues and the legislative process, hear from Congressional guest speakers and on the national lobby day, held May 6, meet with lawmakers and their staff. The College covers all expenses.

Registration for 2009 Advocacy School has almost reached capacity, but if you would like more information about the program, or would like to learn other ways to become involved in the CAP Pathology Advocacy Network, please contact Susan Askew by e-mail or at 202-354-7105.

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