Previous Advocacy Updates

Special Issue: With pathologists facing steep cuts to their Medicare pay next year, Congress passed legislation to mitigate and delay payment decreases to physicians on December 9. The CAP aggressively lobbied Congress to stop the cuts and protect patient access to pathology services before the sharp decreases to payments took effect on January 1, 2022.

On December 2, Congress passed legislation to avert a government shutdown and provide enough funding for federal programs through February 18. While the CAP and other physician associations lobbied lawmakers to use this funding bill to stop Medicare cuts in 2022, Congress neglected to do so. With little time left in the calendar year, congressional leaders are exploring options to address the cuts—including a vote in the House of Representatives later this week.

Following a request for additional details on its payment policy change, Cigna provided the CAP with further clarity on a revised policy for the professional component of clinical pathology (PC of CP) when billed by pathologists. The CAP asked Cigna for additional details on October 26 after the insurer acknowledged the role of pathologists in providing laboratory management and oversight services.

The CAP urged the Biden Administration to change the interim final regulation for the No Surprises Act to align the law’s implementation with the original legislation.

On November 6, the House of Representatives adopted procedural rules for the further consideration of the Build Back Better Act, which contains numerous health care and social spending provisions in President Joe Biden’s agenda. The CAP endorsed several provisions of the reconciliation bill.

Special Issue: On November 2, the Centers for Medicare & Medicaid Services issued the final 2022 Medicare payment regulations, including the final 2022 Medicare Fee Schedule and Quality Payment Program regulations.

The CAP strongly opposed new federal regulations that give insurance companies the upper hand during what should be an impartial, independent dispute resolution (IDR) process as set in the No Surprises Act.

Following a request for additional details on its payment policy change, Cigna provided the CAP with its updated policy to deny claims for the professional component of clinical pathology (modifier 26; PC of CP) when billed by pathologists. The CAP has opposed the policy and has urged the insurer to continue paying for the PC of CP services for all pathologists.

On October 12, over 65 pathologists participated in a “virtual fly-in” and met with their Federal policy makers to lobby Congress to mitigate a 5% Medicare cut to pathology services in 2022.

The CAP has organized a “virtual fly-in” event beginning October 12 for pathologists to meet with their senators and representatives and lobby Congress to mitigate a 5% Medicare cut to pathology services in 2022.

In late September, pathologists received letters from Cigna stating that the insurer would go forward with an updated payment policy on the professional component of clinical pathology it had previously tabled following opposition from the CAP.

The federal government formally urged federal agencies, including the Centers for Medicare & Medicaid Services (CMS), to prepare for the possibility of a lapse in funding and government shutdown.

The FDA approved the CAP for admission to its Network of Experts to provide the agency with additional expertise on pathology and laboratory medicine issues, such as those concerning the COVID-19 pandemic and artificial intelligence.

The CAP successfully advocated to include new CPT codes for pathology clinical consultation services in the proposed 2022 Medicare Physician Fee Schedule but urged the CMS to clarify the codes before implementation.

Building on the 21st Century Cures Act, the CAP engaged with House lawmakers to advance medical research and foster a new era of medical innovation.

The CAP and the Cancer Leadership Council have called on physicians to get the COVID-19 vaccine and protect the patients they serve.

A $1 trillion, bipartisan infrastructure bill passed the Senate on August 10 after months of negotiations, but associations representing physicians and other medical groups have taken issue with plans to use cuts to Medicare to partially pay for the legislation. Congress is expected to address several Medicare issues through the budget reconciliation process after elected officials return from the August recess. The CAP will be actively lobbying the Congress throughout this process on a number of issues impacting pathology.

The CAP and the American Medical Association opposed the recent action taken by the Department of Veterans Affairs that nonphysicians can provide health care services.

On July 22, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) to import and increase the supply of “blue-top” test tubes.

On July 13, the CMS released the proposed 2022 Medicare physician fee schedule by including CAP-developed pathology Consult Codes.