Advocacy News

• CAP urges Medicare payment stability
• Pay reform legislation supported by CAP advances in House Committee
• New House bill targets LDT regulations
• Preview your 2024 MIPS performance data
• RFK Jr. names interim surgeon general amid confirmation delays
• HHS removes leaders of preventive services task force

The CAP is urging lawmakers to boost Medicare pay for pathology services.

For a House committee hearing examining payment for physicians services, the CAP outlined its priorities to stabilize Medicare and protect access to diagnostic testing in a statement submitted for the record.

The impact: We emphasized that ongoing payment instability threatens pathologists’ ability to provide care and invest in laboratory services.

By the numbers: 71% of pathology leaders recently reported that payment cuts hurt practice revenue and staffing.

The CAP view: Accurate diagnosis is a critical outcome in patient care and must be adequately recognized in Medicare quality programs.

• We asked Congress to extend the 2.5% Medicare payment adjustment beyond 2026 until permanent reforms are in place.
• Our statement highlighted growing gaps between rising practice costs and declining reimbursement.
• We also raised concerns about payment policies, including the efficiency adjustment, that do not reflect increased workload and complexity.

Go deeper: Read the full statement and watch a recording of the hearing.

The House Ways and Means Committee unanimously advanced legislation to increase the Medicare budget neutrality threshold.

• This legislation is part of a package of bills supported by pathologists attending our Hill Day in April.

The impact: The bill, HR 8163, aims to reduce payment cuts tied to budget neutrality and improve stability for physicians.

• The legislation was approved by a 44–0 vote in committee.
• Lawmakers continue to explore ways to reduce payment volatility under the Medicare Physician Fee Schedule.

What’s next: House leadership will determine if and how the bill moves to the full House for consideration.

How to help: Visit our Action Center to support legislation that advances and protects the practice of pathology.

Rep. Neal Dunn, MD, (R-FL) has introduced the Enhancing Clinical Laboratory Innovation and Access (Enhancing CLIA) Act to update the regulation of laboratory-developed tests (LDTs).

What’s in the bill: The legislation would provide a framework where laboratories can opt for FDA or third-party reviews for certain LDTs.

• This change would affect laboratories by imposing new reporting requirements and regulatory standards.
• The act would amend both CLIA and the Federal Food, Drug, and Cosmetic Act to reflect current diagnostic practices and recognize third-party affirmations for companion diagnostics.

The big picture: The act underscores that LDTs would be regulated under CLIA, aligning with the ACLA v. FDA court decision in 2025.

• The bill proposes a transition period of two years for implementing the new framework, affecting how labs operate and report test results.

The CAP is reviewing the bill and engaging with its members to discuss how it could affect their practices.

• Any proposal addressing LDTs should strengthen patient protections without creating duplicative or overly burdensome requirements that could reduce access to testing, particularly in hospitals and community laboratories.

The 2024 MIPS Doctors and Clinicians Preview Period is now open through June 11, giving clinicians a chance to review performance data before it is publicly reported.

The impact: This information will be published later this year on Medicare.gov compare tool and in the Provider Data Catalog, making it important to review for accuracy.

• Clinicians can log into the Quality Payment Program (QPP) website using their HARP account to access their preview.
• Users must be logged in as a Security Official or Staff User to view the data.
• Not all quality measures will be publicly reported.

Details to know: 

• For group reporting, select MIPS measures and CAP measures will be publicly available.
• For individual reporting, only select measures will be included.

What’s next: Clinicians should review their information during the preview period and address any concerns before public reporting later this year.

Go deeper: Review CMS' Guide to the Preview Period or watch the Performance Information video. 

Stephanie E. Haridopolos, MD, DABFM, will serve as interim surgeon general while Senate confirmations remain stalled.

• Dr. Haridopolos, a board-certified family medicine physician, serves as principal deputy assistant secretary for health policy and chief of staff to the surgeon general’s office.

The impact: The appointment comes as a growing backlog of federal health nominees delays permanent leadership across key agencies.

• Haridopolos will lead public health advisories and guidance in the interim.
• Confirmation delays continue to create uncertainty across federal health leadership. 

What’s next: A permanent surgeon general will be named once confirmations move ahead.

Health and Human Services Secretary Robert F. Kennedy Jr. has removed two leaders of the US Preventive Services Task Force (USPSTF), an independent panel that guides which preventive services insurers must cover.

The impact: The task force helps determine coverage of services such as cancer screenings and other preventive care under federal law.

The American Medical Association said it was extremely concerned with this action given the task force’s role in making evidenced-based recommendations.

"We strongly urge HHS to restore the USPSTF's long-standing, transparent process for selecting members, specifically clinicians with expertise in the fields of preventive medicine and primary care," said AMA President Bobby Mukkamala, MD.

What's next: The administration is expected to appoint new members as it reviews the task force’s structure and direction.