Read the Latest Issue of STATLINE

May 23, 2017

In This Issue:

CAP Members from left to right, Jonathan L. Myles, MD, FCAP, Kathryn Knight, MD, FCAP, Emily Volk, MD, FCAP, and Patrick Godbey, MD, FCAP.

On May 16, the CAP Advocacy team and members of the Council on Government and Professional Affairs (CGPA) met with Health and Human Services Secretary Tom Price to discuss reducing regulatory burdens on Pathologists.

CAP Members from left to right, Jonathan L. Myles,
MD, FCAP, Kathryn Knight, MD, FCAP, Emily Volk,
MD, FCAP, and Patrick Godbey, MD, FCAP.

Jonathan L. Myles, MD, FCAP, Chair of the Economic Affairs Committee; Kathryn Knight, MD, FCAP, Vice-Chair of the House of Delegates; Emily Volk, MD, FCAP, Vice-Chair of the CGPA and Patrick Godbey, MD, FCAP, Chair of the CGPA, had a high-level discussion on areas where the CAP would like to increase transparency and ensure physician input in regulatory programs that impact pathology, including:

  • Reforming the Medicare Local Coverage Determination process
  • Ensuring physician participation in the mis-valued code initiative
  • Innovation (CMMI) and the Physician-Focused Payment Model Technical Advisory Committee (PTAC)

STATLINE will continue to report on any other updates.

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In March, following advocacy by the CAP with the agency overseeing reforms to the clinical laboratory payment system, the Centers for Medicare & Medicaid Services issued a 60-day delay of the Protecting Access to Medicare Act (PAMA) data submission period for applicable laboratories until May 30, 2017.

The CAP, along with the American Clinical Laboratory Association (ACLA), National Independent Laboratory Association (NILA), and seven others, said they had significant concerns about implementation of the Medicare clinical laboratory fee schedule (CLFS) reform as mandated by PAMA and that applicable laboratories need more time to submit their data. Many laboratories are still in the data collection phase as they struggle with the CMS regulatory requirements, note the signed laboratory organizations. The CMS acknowledged industry feedback in its announcement of the delay.

The data reporting period for PAMA was scheduled to conclude on March 31, 2017, but now applicable laboratories effectively have until May 30, 2017 to submit their required data.

Applicable laboratories must report the required information for all payments received from private health insurers for specific clinical laboratory tests provided between January 1, 2016 and June 30, 2016. The CMS has published a list of 1,300 clinical laboratory services subject to data collection and reporting requirements.

To help laboratories gather their data, the CAP developed pathology specific PAMA resources, including an informative infographic and podcast , to help laboratories understand regulatory requirements and upcoming deadlines. These resources and additional tools can be found on the CAP PAMA resources web page.

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New date – June 28, 2017

In 2018, most pathologists will need to take action to stop penalties from reducing future Medicare payments for their services.

The Centers for Medicare & Medicaid Services (CMS) soon will issue its latest proposed rulemaking that implements provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). On June 28 at 1 PM ET, the CAP will host a 60-minute webinar to discuss the CMS' proposals for participating in the 2018 Medicare Merit-based Incentive Payment System (MIPS) program, including options for preventing Medicare penalties.

Patrick E. Godbey, MD, FCAP, Chair of the CAP Council on Government and Professional Affairs; Jonathan L. Myles MD, FCAP, Chair, of the CAP Economic Affairs Committee; and Diana Cardona, MD, FCAP, Chair of the CAP Economic Affairs Measures & Performance Assessment Subcommittee, will discuss how these proposed Medicare pay changes under MACRA will affect pathologists in 2018.

Register today.

By registering you will also receive a link to a recording of the presentation following the live event. Registrants will receive the link to the recording even if they are unable to attend the session on June 28.

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Following the Memorial Day holiday, STATLINE will next appear in your email inbox on June 6. Please continue to check the CAP Twitter and Facebook accounts for updates from the CAP.

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