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April 25, 2017

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More than 100 CAP members traveled to Washington, DC, to advocate for the pathology specialty and their patients during the 2017 CAP Policy Meeting April 24–26. Throughout the first day, pathologists discussed the present state of reimbursement programs including opportunities for reduced regulations in the current political climate, as well as perspectives from the American Medical Association, the Centers for Medicare and Medicaid, in addition to other issues facing pathologists.

The CAP Council on Government and Professional Affairs Chair Patrick Godbey, MD, FCAP, opened the meeting on April 24 by discussing the challenges facing the specialty and what the CAP is doing to address these challenges, including: the implementation of payment reforms under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); the Pathologists Quality Registry; the CAP's Medicare Local Coverage Determination (LCD) Act legislation; and the oversight of laboratory-developed tests.

During the first session, Dr. Godbey provided an advocacy update on recent challenges and opportunities before the profession. Moreover, Emily Volk, MD, FCAP, Jonathan Myles, MD, FCAP, and Joe Saad, MD, FCAP, provided updates on the work being done by key CAP councils and committees.

"Your physician voice in health care advocacy is crucial in making changes that help pathologists serve their patients," Dr. Godbey said.

This year, the CAP scheduled over 80 CAP members to meet with their respective members of Congress. Since 2012, CAP members have participated in 662 meetings with congressional offices and achieved several victories. For example, physicians successfully advocated for the repeal of the sustainable growth rate (SGR). CAP members also have successfully avoided Medicare payment penalties from the Electronic Health Record (EHR) Meaningful Use program after engaging with members of Congress at previous Policy Meetings and through the CAP's grassroots network PathNET.

CAP to Engage With Lawmakers on LCD Reform

The LCD process continues to be a concern for pathologists and is in need of reform.

The CAP commended the re-introduction of the Local Coverage Determination Clarification Act of 2017 last month in the Senate. The bill would improve transparency and accountability when Medicare contractors implement LCD policies for physician services provided to Medicare beneficiaries. The CAP thanks the Senate bill's sponsors Sen. Johnny Isakson (R-GA), Sen. Tom Carper (D-DE), Sen. Debbie Stabenow (D-MI), and Sen. John Boozman (R-AR) who support the CAPs position on this issue and have been working with the CAP on improving the LCD process. In the current legislation, the CAP calls for coverage decisions to be made by qualified health experts through a transparent process based on sound medical evidence. The CAP, along with the American Medical Association, and coalition members Advanced Medical Technology Association, the Amputee Coalition, the American Society of Clinical Oncology, the American Society of Radiation Oncology, and the US Oncology Network have come together because they believe that LCDs should not limit patient access to needed technologies and services.

On April 26, as part of the CAPs annual Policy Meeting over 80 CAP members will visit congressional offices to advocate for needed LCD reform. They will spend the day in Senate and House offices explaining the need to reform an LCD process that lacks openness and transparency.

A Call for Deregulation and PAMA Update

With the new administration’s focus on deregulation, Dr. Myles, Chair of the CAP Economic Affairs Committee, lead an interesting panel on Affordable Care Act (ACA) Repeal and Replace and the possible opportunities for the CAP to address regulatory issues that negatively impact pathology. Dr. Myles, along with Julie Khani, President of the American Clinical Laboratory Association and Bruce Scott, MD, Vice Speaker of the American Medical Association, discussed the repeal and replacement of the ACA and how that creates an opportunity to address regulatory issues that negatively impact pathology. The panel discussed how pathologists and laboratory professionals should advocate for a significant reduction in regulatory burdens. Dr. Scott reviewed the current ACA regulations, the ACA stabilization rule, and MACRA transitions. Ms. Khani reviewed the PAMA data submission delay victory for applicable laboratories and their advocacy work with the CAP. The CAP has resources for members to help them prepare and submit their PAMA data.

Update on MIPS Requirements

CAP leaders and policymakers discussed the reforms to the Medicare program and the impact on pathology. Dr. Volk, the vice-chair of the CAP Council on Government and Professional Affairs, led a panel discussion on Demystifying the Merit-Based Incentive Payment System (MIPS). Dr. Volk was joined by CMS Jean Moody-Williams, Deputy Center Director, Center for Clinical Standards and Quality, and Kevin Donnelly, CEO/Executive Director, Physician Consortium for Performance Improvement Foundation.

Ms. Moody-Williams opened the panel by breaking down the Quality Payment Programs (QPP) and MIPS requirements for non-patient-facing physicians, such as pathologists. She announced that CMS will send out the non-patient facing letters regarding these requirements this week or in the near future.

Dr. Volk reviewed QPP programs, specifically MIPS and how the rules will apply to pathologists and the concerns pathologists have with implementation of the new programs. For the 2019 payment year, the CAP is working to ensure pathologists can comply with MIPS by developing the Pathologists Quality Registry, which will be available later this year.

Former Senate Majority Leader Tom Daschle engaged members in a poignant discussion about the current disruptive area of health care policy. He noted the key intersection between technology and health care and touched on the triple aim in reforming health care—improving patient experience, improving the health of populations, and reducing the cost of health care. He talked about being constructive rather than destructive in policy and that successful health and social policies were based on bipartisan support. The members attending the Policy Meeting asked engaging questions regarding the repeal and replacement of the ACA.

Look for more coverage of the 2017 Policy Meeting in the next issue of STATLINE.

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As part of the organization's ongoing efforts to educate policy influencers—members of Congress, congressional staff, regulatory agency officials, and health policy experts—the CAP is running advertisements in the Washington area throughout April, including the 2017 CAP Policy Meeting April 24-26.

The advertisements are intended to bring greater attention to the role of pathologists in patient diagnosis. The CAP’s digital ads appear in several national and local media outlets based in Washington.

A core function of the CAP's overall messaging is that policy influencers, among others, recognize the value of pathologists in bettering patient care. One advertisement reads, "Pathologists unlock the mysteries of cancer." Another message reads "Pathologists are physicians whose diagnoses drive care decisions made by patients, primary care physicians, and surgeons."

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The CAP is fielding the 2017 Practice Characteristics Survey to gather data from individual pathology practices regarding their economics, demographics, and market trends. The survey is open for two more weeks, until May 12.

On April 10, pathologists received an email from with a link that is unique to the pathologist receiving the invitation. Respondents are eligible for a drawing for one of four $150 Amazon gift cards. CAP members Edward Jones, MD, FCAP, and Kevin Golden, MD, FCAP, are the first two Amazon Gift Card winners. Congratulations Dr. Jones and Dr. Golden.

If you have not received your invitation, please contact us at This survey is available to board-certified pathologists who are currently practicing in the US. The survey excludes full-time retirees, pathologists practicing in different countries, and junior members of the CAP.

The survey should take 15 minutes to complete. The CAP will share the survey findings with its members in a full report and provide early access to the data to those who finish the survey.

All responses are kept strictly confidential. Responses will be reported in aggregate form only. No individual practice information will be uniquely identified or shared.

The CAP will use the data in its advocacy efforts with policy influencers, health care leaders, and other stakeholders to increase understanding of the significant role and value of the pathologist in the delivery of patient care.

Survey participants are helping the CAP to better serve its members. The survey will capture:

  • Vital practice member characteristic data
  • Information on the concerns and challenges of the CAP member
  • Compensation data, including salary and benefits
  • Practice-related data

Complete your survey soon before it closes on May 12.

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With the 2017 CAP Policy Meeting underway, one may wonder what advocacy resources the CAP offers to members. PathNET is the CAP's grassroots advocacy network and a resource for CAP members to connect with their elected officials at the federal and state level. Through PathNET, pathologists can build relationships with their legislators and assist the CAP in achieving our legislative goals.

PathNET tools available include:

Go to the PATHNET web page for more information and resources on the CAP's grassroots network.

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