Advocacy Update

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July 21, 2020

In this Issue:

CAP-Led Research Shows a 40% Pathology Workforce Undercount in Published Reports

Recently the CAP highlighted the undercount of US pathologists in an article published by the Journal of the American Medical Association (JAMA) Network Open and further called for previous works citing the data to be corrected. The JAMA Network Open article highlights new CAP-led research that shows a 40% pathology workforce undercount in the US physicians database.

The JAMA Network Open article “Re-evaluation of the US Pathologist Workforce Strength” by Stanley J. Robboy, MD, FCAP, et al., explored unintended flaws in the methods used by various entities, and why most recent workforce counts have understated by about 40% the number of actively practicing pathologists in the US.

The CAP-led study followed up on a JAMA Network Open 2019 article with workforce data that concluded that the number of active pathologists dropped from 15,568 to 12,839 between 2007 and 2017. These data were based on information published by the American Association of Medical Colleges (AAMC), which drew from the American Medical Association (AMA) Physician Masterfile.

The authors recommend that AAMC change how it reports pathology workforce numbers to include all physicians, the AMA Masterfile, who are actively practicing pathologists. Currently, the AAMC database does not include those pathologists who are also trained any of the various pathology subspecialties, such as cytopathologists, dermatopathologists, hematopathologists, forensic pathologists and eight others.

The authors also recommend that all previously published reports, presentations, and other uses of the data from the AAMC be reexamined. Statements based on the AAMC data that report a pathology workforce shortage or decline must be reconsidered.

Recent surveys on the pathologist workforce have shown the job market for pathologists to be healthy. For example, according to a study published in the Archives of Pathology and Laboratory Medicine earlier in 2020, 45.5% of leaders of pathology practices responding to a CAP survey had sought to hire at least one pathologist in 2017.

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CAP Concerned as HHS Streamlines COVID-19 Lab Reporting

On July 15, the Department of Health and Human Services (HHS) changed COVID-19 laboratory reporting procedures for hospitals, further streamlining the pandemic process. According to the new guidance, the HHS will now require hospital laboratories to report COVID-19 testing data and deaths directly to the HHS, rather than to both the HHS and the Centers for Disease Control and Prevention (CDC) as previously required. The CAP appreciates the HHS’ attempt to streamline the hospital laboratory reporting process. However, the CAP still remains concerned about the COVID-19 data reporting, so it does not cause confusion or duplication for pathologists and laboratories.

The new HHS guidance requires hospital laboratories conducting in-house testing to report directly to the HHS. The CAP is concerned about the confusion on how both the new HHS guidance and the previous one will work together.

On June 26, the CAP asked the HHS to describe the reporting burdens and clarify new requirements regarding the reporting of COVID-19 clinical laboratory test results and data elements. The CAP’s advocacy follows HHS regulations, released on June 4, which required laboratory reporting of COVID-19 test results and other clinical data elements to health agencies. Laboratories are required by a newly enacted law to report results from each COVID-19 test they provide to patients to the HHS as part of surveillance activities for the disease.

The new HHS COVID-19 reporting system aims to track the pandemic. The CAP will continue to work with the HHS to reduce the clinical laboratory reporting burdens during this critical time.

State Advocacy Win: GA Governor Signs Two Out-of-Network Bills Into Law Backed by GAP, CAP

Georgia Governor Brian Kemp singed two critical out-of-network bills backed by the Georgia Association of Pathologists (GAP) and the CAP on July 17. The recent state advocacy win in Georgia shows how the CAP’s strong partnership with state pathology societies bolster advocacy efforts at the state level.

The first law (HB 888) applies to out-of-network services at in-network facilities. It provides out-of-network balance billing protections for patients and an equal payment and arbitration provision for physicians.

Under the second law (HB 789), GA health plans will now be required to indicate to enrollees if certain physician specialists are under contract at in-network facilities.

The CAP advocates for states to require health plans to have adequate networks of hospital-based physicians, including pathologists.

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PathPAC Members Discuss Impact of COVID-19 with Rep. Estes

On Friday, June 12, PathPAC, members met virtually with House Ways & Means Committee Rep. Ron Estes (R-KS) to discuss the current COVID-19 pandemic and the impact of diagnostic testing supplies. PathPAC is the CAP’s political action committee. Rep. Estes has voted for the CAP-backed surprise billing legislation, funding of the Paycheck Protection Program, and has supported key CAP-backed health care legislation that puts pathologists first.

Over 35 PathPAC members from Kansas participated in virtual meeting with Rep. Estes, providing an opportunity to educate Congressional leaders on the needs, work, and importance of pathologists. Additionally, Rep. Estes has pathologists sitting in his district’s Health Care roundtable.

During the meeting, CAP PathPAC members discussed the current health care landscape, the lack of testing supplies in Kansas, and reimbursement concerns during COVID-19. Afterward, Mark Synovec MD, FCAP said that the meeting, “was enlightening… to explain to [Rep. Estes] what was happening in the trenches of Kansas,” Dr. Synovec said. “It was a great discussion as the group outlined what we really need from the government, as well as relaying things that they have done that impede our service to Kansans, for example the current upside down reimbursement rates for SARS-CoV-2 PCR testing.”

PathPAC is the only political entity that pursues the election and reelection of candidates for federal office who understand the value of pathology in improving patient care and advancing the CAP's position on key issues related to pathology. Contributions to PathPAC by CAP members is the most effective way for pathologists to join together to influence public policy.

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Webinar on August 5: 2020 Medicare Payment for Pathologists

The CMS will soon issue its proposed updates to the 2021 Medicare Physician Fee Schedule and the Quality Payment Program regulations, including the Merit-based Incentive Payment System (MIPS). The CAP will host an exclusive webinar to August 5 at 1 PM ET/ Noon CT where CAP experts will review regulatory changes that will impact payment for services and pathologists’ participation in MIPS.

Webinar presenters will be the Chair of the Council on Government and Professional Affairs Jonathan Myles, MD, FCAP; Chair of the Economic Affairs Committee W. Stephen Black-Schaffer MD, FCAP; and Vice Chair, Economic Affairs Committee Diana Cardona, MD, FCAP.

During the 60-minute webinar, attendees will learn about updates to the 2021 Medicare Physician Fee Schedule and the Quality Payment Program regulations and its impact on pathologists. The CAP panel will also answer questions from attendees.

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Need a Break? Take the Advocacy News Quiz

Need a break, then take the July Advocacy News Quiz. See how you compare against your fellow CAP members’ in the July News Quiz.

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Breaking Advocacy News? Check out the Advocacy Twitter Channel

Want up to the minute CAP Advocacy news? Then follow us on twitter at CAPDCAdvocacy, where you will be the first to know about CAP Advocacy wins, see your fellow members engage with congressional leaders on key policies affecting the practice of pathology and, of course, breaking Advocacy news.

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