Read the Latest Issue of Advocacy Update
January 21, 2020
In This Issue:
How the CAP, AMA Are Working to Protect Scope of Practice Policies
The CAP and the American Medical Association (AMA) took issue with proposed scope of practice policy changes and their potential adverse impacts on the quality of patient care.
To protect the quality of laboratory medicine, the CAP clearly stated its support for physician-led health care to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma. In a January 17 letter, the CAP outlined the impact of the potential scope of practice changes related to diagnostic laboratory testing and interpretation of clinical laboratory tests. Our feedback is in response to a CMS request stemming from the President’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors, which included direction to reduce current Medicare supervision requirements regulations for non-physician professionals.
The CMS has already made regulatory scope of practice changes in several payment regulations, including redefining physician supervision for services furnished by physician assistants, allowing therapist assistants to perform maintenance therapy under the Medicare home health benefit, and reducing the minimum level of physician supervision required for all hospital outpatient therapeutic services.
In a separate letter, the AMA, the CAP, and other physician groups expressed their concerns with the far-reaching implications of the CMS’ request. In the letter, the groups urged against eliminating physician supervision provisions without a review of education and training and the impact on overall cost and quality of care. “While all health care professionals play a critical role in providing care to patients, their skillsets are not interchangeable with that of a fully trained physician,” the letter stated. “The scope of practice of health care professionals should be commensurate with their level of education and training, not based on politics. Patients – and in this case Medicare patients – deserve nothing less,” the groups said in the letter.
The CAP will continue to engage with the administration on this issue.
Hospitals Sue Medicare Over 2020 Site-Neutral Payment Cuts
Hospitals filed a lawsuit against the Trump Administration for cutting Medicare reimbursements through site-neutral payment policies in 2020. The CAP has opposed similar Medicare policies that result in inadequate payments that fail to account for resources used to care for patients treated in outpatient settings.
The American Hospital Association, Association of American Medical Colleges, and other hospital groups filed the lawsuit on January 13 against the Department of Health and Human Services (HHS) and the CMS, which administers the Medicare program. The complaint states that a recent US District Court decision determined the federal agency exceeded its authority when it previously reduced Medicare reimbursements for certain hospital outpatient services.
“Nonetheless, CMS pressed ahead with the same unlawful payment cuts for 2020,” the American Hospital Association said. The 2020 final Hospital Outpatient Prospective Payment regulation implemented reductions to Medicare payment rates for certain clinic visit services provided at specified off-campus hospital provider-based departments. The off-campus departments are practice locations of a hospital that are not located in immediate proximity to the main building of their affiliated hospital, but are integrated with and controlled by the main hospital, and are considered to be part of the hospital. The regulation targeted select services for cuts.
“CMS cannot exercise its limited authority in a manner so flagrantly inconsistent with the Medicare statute,” the American Hospital Association said.
Overwhelmed with Medicare Payment Policies? The Pathologists Leadership Summit Can Help
Are you overwhelmed with the many reimbursement and payment policies your pathology practice has to handle? You’re not alone—learn how to lead your laboratory through change at the Pathologists Leadership Summit.
This is an exclusive opportunity for CAP members to elevate leadership skills, take action, and be more effective advocates for positive change—particularly now that the Spring House of Delegates Meeting and our annual Hill Day are also part of this event.
The Pathologists Leadership Summit will help you better manage your practice, achieve greater influence, and establish and maintain relationships with the legislators who make decisions that affect your specialty.
There is no fee to attend this event, and it includes CME credits. The Pathologists Leadership Summit will give you exclusive access to unparalleled education, training, and brainstorming sessions with key CAP leaders to inspire the leader within you.