Advocacy Update

May 9, 2023

In this Issue:

Take Action: Urge Congress to Stop 2024 Medicare Cuts

On the heels of a successful 2023 Hill Day that saw nearly 100 CAP members meet with 145 congressional offices, pathologists have amassed tangible legislative momentum — but we need to build on that by continuing to contact legislators. 

Last year we fought against Medicare cuts to your pathology payments, but these increased cuts are threatening your pay once again. It is time to answer the call and fight back.   

Absent congressional action, pathologists will face a 6.5% cut in 2024 to help fund payment increases for evaluation and management (E/M) services. These cuts combined with the lack of an inflationary update to the Medicare Economic Index represent significant negative financial factors. 

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CAP, 100+ Medical Societies Applaud Effort to Peg Medicare Pay to Inflation Index

The CAP and more than 100 other medical societies thanked congressional leaders in the House of Representatives for introducing a bill to adjust Medicare payment rates with an inflation-based index that will provide greater stability to physician practices. The CAP has worked with a strong coalition of physician- and other provider-based organizations to oppose Medicare cuts and strengthen the Medicare system.

On May 3, the coalition group sent a letter applauding the introduction of the Strengthening Medicare for Patients and Providers Act to Reps. Raul Ruiz, MD (D-CA), Larry Bucshon, MD (R-IN), Ami Bera (D-CA), and Mariannette Miller-Meeks, MD (R-IA). The bill, HR 2474, would utilize the Medicare Economic Index to provide the physician payment system with annual pay rate adjustments. Costs to operate a physician practice have gone up 47% since 2001, but Medicare payments to physicians have declined 26%, the representatives said.

Congress has enacted a series of short-term fixes to mitigate Medicare payment cuts to pathologists and other physicians in recent years and should continue to do so until permanent reforms can be enacted. Fortunately, HR 2474 gives lawmakers an opportunity to enact one payment reform measure that will guarantee payment rates keep pace with inflation and help maintain patient access to timely and quality care.

“Congress has a unique opportunity to adopt comprehensive, transformative reforms to the Medicare payment system and we applaud your leadership in introducing this legislation,” the letter said. “We look forward to working with Congress to ensure passage of HR 2474 and continue conversations around further payment reform to ensure America’s seniors continue to receive access to the high-quality care they deserve.”

Bipartisan Group of Senators Reintroduce GME Funding Bill

Democratic and Republican senators reintroduced the Resident Physician Shortage Reduction Act on April 27 to increase Medicare-supported training slots and address physician shortages in the near- and long-term. The bill’s introduction followed the reintroduction of a bipartisan companion bill in the House in late March. The bill provides 14,000 new Medicare-supported graduate medical education (GME) slots over seven years.

The CAP has supported more GME slots to address projections of physician shortages of primary care and specialty physicians. During the CAP’s 2023 Hill Day on April 18, pathologists spoke to their representatives and senators about the legislation and urged them to support the bill, which is championed by the Association of American Medical Colleges (AAMC).

Medicare pays for direct GME, the costs of educating residents, and indirect medical education to cover the generally higher costs teaching hospitals to incur. Congress made a critical initial investment in the physician workforce by providing 1,000 new Medicare-supported GME positions in the Consolidated Appropriations Act of 2021, the first increase of its kind in nearly 25 years, and an additional 200 Medicare-supported GME positions in the Consolidated Appropriations Act of 2023.

The United States is facing a shortage of up to 124,000 physicians over the long-term, according to a recent study from the AAMC. This has been exacerbated by an aging physician population, rising rates of physician burnout, and early retirement due to the COVID-19 pandemic.

In the Senate, the Resident Physician Shortage Reduction Act (S 1302) is sponsored by Sens. Bob Menendez (D-NJ), John Boozman (R-AR), Majority Leader Chuck Schumer (D-NY), and Susan Collins (R-ME).

Reminder: Government Ends COVID-19 Public Health Emergency on May 11

With the COVID-19 public health emergency ending on May 11, refer to these resources and guidance regarding how the government will manage flexibilities and temporary measures instituted during the pandemic. As a reminder, remote sign-out for pathologists will still be allowed without the need of a separate CLIA certificate.

Read the CAP’s updates on public health emergencies.

Refer to FAQs from the Centers for Medicare & Medicaid Services (CMS) on waivers and flexibilities as the emergency expires.

FDA Warns Laboratories Over Threats to Laboratory Cybersecurity

Cybersecurity vulnerabilities affecting laboratory equipment software led the Food and Drug Administration (FDA) to alert clinical laboratory personnel about the possibility of unauthorized users gaining access to laboratory equipment on April 27. The FDA has asked laboratories to be aware of required actions to mitigate cybersecurity risks. The CAP works with federal agencies to protect patient safety against various threats, including those in cyberspace.

The specific vulnerability affected the Universal Copy Service software in the Illumina MiSeqDx, NextSeq 550Dx, iScan, iSeq 100, MiniSeq, MiSeq, NextSeq 500, NextSeq 550, NextSeq 1000/2000, and NovaSeq 6000 sequencing instruments, the FDA said. There are no reports of this vulnerability being exploited, but an unauthorized user could:

  • take control of laboratory equipment remotely
  • alter settings, configurations, software, or data on the instrument or a customer’s network
  • impact genomic data results in the instruments intended for clinical diagnosis, including causing the instruments to provide no results, incorrect results, altered results, or a potential data breach

Illumina has developed a software patch to protect against the exploitation of the vulnerability. On April 5, Illumina sent notifications to affected customers to check their instruments and medical devices for potential breaches.

Related, on May 1, the FDA published a tip video on cybersecurity incident preparedness and response. More information from the FDA regarding cybersecurity is available online.

Podcast: Hill Day Experiences and Your Monthly Recap

Listen to our latest Advocacy Update podcast for in-depth interviews and to catch you up on news you might have missed. For this month’s recap, you will hear from Victoria Jones, MD and Eric Loo, MD, FCAP as they discuss their time lobbying Congress during the CAP’s 2023 Hill Day.

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Are You Ready for May’s News Quiz?

Test your knowledge of the last month’s advocacy activities with our Advocacy Update news quiz. About 150 of your colleagues took the previous month’s quiz. May’s quiz is just three questions – can you get all of them right?

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