December 14, 2021
In this Issue:
- Senate Considers Passage of Build Back Better Act; CAP Tracking Health Priorities
- AMA, AHA File Lawsuit Over No Surprises Act Implementation
- Senate Votes Against Federal Vaccine Mandate; Court Rules in Favor of Businesses
- Pathologists Quality Registry Earns 2022 Approval to Enhance Practice Performance & Payment
- Biden Administration Extends Provider Relief Fund Reporting Period for One More Week
- 2021 Webinar: CAP Experts Provide Pathology Consultation Codes Implementation Tips
- Missed Our No Surprises Act Implementation Webinar? Watch the Recording
- Test Your Advocacy Knowledge
Senate Considers Passage of Build Back Better Act; CAP Tracking Health Priorities
While Congress successfully passed several year-end priorities on December 9, the CAP is still engaging lawmakers on health care provisions in the Build Back Better bill. The Build Back Better legislation aims to improve patient’s lives nationwide by expanding access to health insurance and enact several other priorities of the Biden Administration.
The Build Back Better Act previously passed the House of Representatives in November on a party-line vote. Senate Democratic leaders are negotiating within their own caucus to reach an agreement on a final bill. Over the past few days, key Senate committees released separate pieces of the legislation. The CAP is reviewing the legislative language as it is released.
The CAP has endorsed several provisions in the bill. These items include:
- $7 billion to support public health infrastructure activities
- $2 billion in funding for grants for modernizing projects to increase capacity and update hospitals and other medical facilities
- $5 billion for critical manufacturing supply chain resilience
- $1.4 billion for renovation, expansion, modernization of state and local public health lab infrastructure, including money for Centers for Disease Control & Prevention (CDC) laboratories
- $1.3 billion to prepare and respond to public health emergencies, including shoring up the strategic national stockpile supply chains, global and domestic vaccine manufacturing, biosecurity, and therapeutics
- Funding for social determinants of maternal health
- Expanded health coverage for low-income populations
AMA, AHA File Lawsuit Over No Surprises Act Implementation
The American Hospital Association (AHA) and American Medical Association (AMA) filed a lawsuit against the federal government over the misguided implementation of the federal surprise billing law on December 9. The CAP also has strongly opposed the 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.
The No Surprises Act takes patients out of the middle of billing disputes between physicians and commercial health insurers and is set to take effect January 1, 2022. According to the lawsuit, certain provisions in the regulations implementing the law place a heavy thumb on the scale on the IDR process, which now benefits the interests of health insurance companies. The skewed process will ultimately reduce access to care for patients, the associations said.
The CAP has urged the Biden Administration to revise the regulation to align the law’s implementation with the original legislation. Specifically, the regulation for the IDR process disregarded Congress’s intentions to create a fair system where physicians and health insurers can resolve disputes without one factor having more weight over others in the final payment determination.
The AHA, AMA, and their co-plaintiffs filed their lawsuit against the departments of Health and Human Services, Labor, and Treasury, along with the Office of Personnel Management in the US District Court for the District of Columbia. Read the filed complaint and motion to stay.
Senate Votes Against Federal Vaccine Mandate; Court Rules in Favor of Businesses
On December 8, the Senate voted to void the Biden administration’s requirement that large private employers require their workers to be vaccinated against COVID-19. The CAP has supported vaccine requirements for health care workers and supports policies by facilities and businesses that ensure employees are fully vaccinated or tested weekly for the coronavirus disease.
Congress has the authority to object and nullify regulations through the Congressional Review Act. While the Senate’s action cleared one hurdle, the House would also need to pass a similar resolution. However, the White House said if this measure reached President Joe Biden’s desk he would veto it. The final Senate vote was 52-48 with two Democrats joining Republicans.
Federal Judge Blocks Vaccine Mandate
Before the Senate vote, a federal judge issued a stay order to prevent the new Occupational, Safety and Health Administration’s (OSHA) regulations for large employers from taking effect. The judge agreed with the plaintiffs in BST Holdings, LLC v. OSHA who contend the rules are an overreach of the OSHA’s authority.
On December 1, the CAP joined an amicus brief in support of the requirements. The amicus brief stated that the plaintiffs ignored the scientific evidence showing that workplaces are at risk for both transmission and infections with the coronavirus. The Biden Administration’s vaccine rule for large companies is based on the latest scientific evidence and would prevent thousands of hospitalizations and deaths from COVID-19.
Pathologists Quality Registry Earns 2022 Approval to Enhance Practice Performance & Payment
On December 13, the CAP’s Pathologists Quality Registry once again received its qualified clinical data registry status from the Centers for Medicare & Medicaid Services (CMS). This recognizes the CAP’s significant investment to help members demonstrate quality and maximize scoring potential in MIPS. The Pathologists Quality Registry provides practice-specific guidance on success in the MIPS program, and provides pathology practices with real-time performance benchmark reports.
To support pathologists, the CAP’s registry is the only one to offer higher-scoring, pathology-specific quality measures and the ability to integrate with a practices’ laboratory information system or billing system for automated and simplified data collection for practices that prefer not to use the web data entry tool. The registry offers a choice of 15 quality reporting measures, most of which are exclusively available in the CAP’s registry.
The Pathologists Quality Registry is the only MIPS reporting option with measures that potentially allow large pathology practices to reach the scoring threshold to avoid a penalty, as well as the potential to reach the exceptional performance threshold. Small practices can maximize their bonus potential score with the CAP’s registry, too.
Biden Administration Extends Provider Relief Fund Reporting Period for One More Week
The Biden Administration announced that it will extend the portal for Provider Relief Fund reporting from 9 AM ET on December 13 through 11:59 PM ET on December 20. This is the final week for pathologists to report on Reporting Period 1 payments.
During this week, relief fund recipients may register, request corrections, and/or submit their report on relief fund payments received prior to June 30, 2020. Providers who submitted their reports before November 30, 2021 may request to have their report reopened for revisions by contacting the Provider Support Line (866-569-3522).
The Department of Health and Human Services (HHS) released details on reporting requirements for recipients of PRF payments. This HHS announcement included improvements to the requirements, such as expanding the amount of time providers will have to report information, reducing burdens on smaller providers, and extending key deadlines for expending PRF payments for recipients.
All reports must be finalized and submitted before December 20, 2021 at 11:59 PM ET to be compliant with the terms and conditions of the PRF program.
2021 Webinar: CAP Experts Provide Pathology Consultation Codes Implementation Tips
On Thursday, January 20 at 1 PM ET/ 12 PM CT, the CAP will offer a complimentary live webinar where CAP experts will review implementation tips for the Pathology Consultation codes and answer questions. Webinar presenters will be the Council on Government and Professional Affairs Chair Jonathan Myles, MD, FCAP; and Economic Affairs Committee Vice-Chair Ronald McLawhon, MD, FCAP.
Missed Our No Surprises Act Implementation Webinar? Watch the Recording
Test Your Advocacy Knowledge
Think you know CAP advocacy, well let’s put that to the test! Last month, nearly 100 pathologists took the November news quiz. See how you compare against your fellow CAP members in the December News Quiz and brag about your top scores on social!