Advocacy News

• CAP urges health officials to target anti-fraud efforts
• Reminder: PAMA reporting opens May 1
• Stronger state societies, stronger advocacy
• HHS restores ONC name, refocuses health tech leadership

The CAP submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to its request for information under the Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative on fraud and abuse in federal health programs.

The CAP view: We support efforts to combat health care fraud and abuse, including action against inappropriate self-referral, kickbacks, and testing without medical necessity. 

• We urged CMS to clearly distinguish documented fraud from compliant laboratories operating within established clinical guidelines.

The impact: The CMS is considering policy changes that could affect coverage, payment, and administrative requirements for lab services, particularly in molecular diagnostics.

The bottom line: Broad policies risk penalizing compliant laboratories and limiting patient access without targeting the root causes of fraud.

What’s next: We will stay engaged as CMS reviews feedback and considers next steps.

The next Protecting Access to Medicare Act (PAMA) reporting opens May 1 reporting period begins May 1. Now is the time to review updated resources and confirm that you’re ready.

The impact: This reporting cycle directly affects Medicare payment rates for clinical laboratory tests. Incomplete or inaccurate reporting can lead to downstream payment disruptions. 

Next steps:

• Review updated PAMA reporting guidance and resources.
• Confirm reporting requirements for your laboratory or practice.
• Prepare your data ahead of the May 1 start date.

Go deeper: Review PAMA reporting requirements and resources.

What's next: At the HOD/PLS meeting, a session on April 27 will cover PAMA implementation challenges and long-term solutions for laboratory payment.

Want to expand engagement and strengthen advocacy in your state? At HOD/PLS, the session "Stronger State Societies = Stronger Advocacy" takes a candid look at what's working—and what isn't—when it comes to building stronger state pathology societies (SPS).

The impact: Strong state societies drive local advocacy, member connection, and visibility for pathology.

What to expect:

• Real-world challenges, wins, and lessons learned from SPS presidents
• CAP data on what state leaders are asking for right now
• Breakout groups to exchange ideas and take-home strategies

The bottom line: You’ll leave with practical, peer-tested ideas you can bring back to your society right away.

What’s next: Register for HOD/PLS to join this session on Sunday, April 26, 2:30–3:30 PM.

The Department of Health and Human Services (HHS) is reversing a 2024 reorganization and restoring the Office of the National Coordinator for Health IT (ONC) name, refocusing the agency on nationwide health IT interoperability and data sharing.

The impact: This could shape how laboratory and pathology data are shared, accessed, and used in clinical care.
Zoom out:

• Enterprise IT, cybersecurity, and data operations have been moved out of ONC, enabling them to concentrate on health IT policy, standards, and certification.

The bottom line: A more unified federal approach to health data and technology could influence how information flows across the health care system.

What’s next: HHS will continue implementing this structure as it advances policies on interoperability, data use, and AI in health care.

Go deeper: Read more about the HHS announcement.