Advocacy Update

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An organized advocacy campaign led by the CAP persuaded the federal government to allow pathologists to work remotely.

The Trump administration announced the temporary waiver giving pathologists the regulatory flexibility requested by the CAP on March 26. CLIA regulations mandate that pathologists must perform diagnostic tests in CLIA-licensed facilities. But the Centers for Medicare & Medicaid Services (CMS) stated during this public health emergence, it will exercise enforcement discretion to ensure pathologists may review pathology slides remotely using these guidelines.

In addition, the CLIA regulations for cytology state that cytology slide preparations must be evaluated on the premises of a laboratory certified to conduct testing in the subspecialty of cytology. However, as has been done in previous public health emergencies, the agency is exercising enforcement discretion and it will not enforce the requirement to have a separate certificate for laboratories that are located at temporary testing sites, provided that the designated primary site or home base has a CLIA certificate and the work being performed in the temporary testing site falls within the parameters of the primary site’s certificate.

The CAP mobilized its members to directly lobby the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) to give pathologists the workforce flexibility they need to manage the COVID-19 pandemic. Our successful grassroots efforts also spurred Congress to respond on March 25 with a letter signed by 37 members of the House of Representatives pressing the CMS to grant the waiver. The CAP had worked with the letter’s leaders, Rep. Buddy Carter (R-GA) and Rep. Bobby Rush (D-IL), to gather the signatures in just 48 hours.

The CAP campaign further marshaled support from the greater health care community, including the American Hospital Association, American Medical Association, American Clinical Laboratory Association, Association of Pathology Chairs, and American Society of Clinical Pathology joining our cause.

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