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- CAP Urges Congress to Stop Insurance Companies from Devaluing Pathology Services
The CAP demanded that Congress take action to stop health insurance companies from devaluing pathology services. In its advocacy on private health sector issues, the CAP champions policies protecting the value of pathology and laboratory services.
In a July 14 letter to House Ways and Means Committee leadership, the CAP detailed how health insurance companies have, and continue to, devalue diagnostic pathology services. For example, the CAP stated that “with passage of federal legislation to address surprise billing, health insurance plans are increasingly relying on narrow and often inadequate networks of contracted physicians, hospitals, and other providers to shift medically necessary health care costs onto their enrollees.”
In addition, the CAP outlined difficulties with UnitedHealthcare’s Designated Diagnostic Provider program, where the CAP has urged UnitedHealthcare to immediately and permanently cease implementation of this program because of the burden and confusion it created for pathologists and their patients. “Even with recent modifications, the CAP believes UnitedHealthcare policies that subject patients to an increased payment for services received at in-network, but non-DDP facilities, is counter to efforts to protect patients and eliminate surprise medical bills,” the CAP stated in the letter.
The CAP also urged Congress to review how health insurance companies cut or stop reimbursements to critical patient services without any notification, creating a health care desert in rural and smaller pathology practices. The CAP will continue to advocate for pathologists to ensure fair reimbursement from private insurance companies.