The CAP has urged Congress to improve the coverage of pathology services and continue pandemic preparedness efforts as it drafts new measures under its 21st Century Cures initiative. As a result of the advancement of medical research and health care delivery stemming from the initial 21st Century Cures Act, Congress is considering a new set of reforms that aim to build on the success of 21st Century Cures and Cures 2.0 by focusing on ways to modernize coverage and access to life-saving cures.

In June, Reps. Diana DeGette (R-CO) and Larry Bucshon, MD (R-IN) circulated a request for information from stakeholders, including the CAP, to help guide legislators in refining strategies and ensuring a legislative path under the 21st Century Cures initiative that will be beneficial to patients and the health care system.

In an August 2 comment letter, the CAP urged legislators to consider the following:

Local Coverage Determination (LCD) Improvements

• Thoughtful discussion and timely feedback from stakeholders and advocates who have unique insight into the nature of local practice and the needs of local patient populations.
• Transparency, consistency, and clarity around how stakeholders are expected to participate in the LCD process.
• Transparency regarding the status of reconsideration requests and a timeframe for Medicare Administrative Contractors (MACs) to complete a reconsideration request for a revision to an LCD.
• Making public the performance of each MAC with respect to performance requirements and measurement standards.

Meaningful Access to Federal Health Plan Claims Data

• Ensuring clinician-led clinical data registries have meaningful access to claims data will enable such entities to better track patient outcomes over time, expand their ability to assess the safety and effectiveness of medical treatments, and provide them with the information necessary to assess the cost-effectiveness of therapies.

Ensuring Medicare Coding Consistency

• Continue to utilize a HIPAA-compliant code set, which requires all providers, clearinghouses, and payors to use the American Medical Association Current Procedural Terminology (CPT) code set.

Continuing Pandemic Preparedness Efforts

• Consider policies to standardize electronic laboratory reporting and authorize funding to enhance laboratory information systems at the federal and state levels to ensure critical data on disease spread can be shared with public health agencies.
• Support the creation of national standardized minimum data reporting requirements and formats in which clinical laboratories would be required to report only to the state in which the laboratory is located.
• Ensure there is a mechanism to provide adequate coverage and reimbursement of tests during a public health emergency so that the public can access tests as needed and laboratories have enough revenue to continue operating.

The CAP urged Congress to work with them to continue improving treatment options and increasing important research for patients.