Advocacy News

• Win at the AMA: Pathology seeks to end health plan 'steering' tactics
• AMA backs CAP-led policy targeting deceptive marketing by training programs
• Longest government shutdown ends
• New guidance on DOAC testing
• CAP experts to break down Medicare and QPP updates in Dec. 5 webinar
• House of Delegates seeks members

The American Medical Association (AMA) House of Delegates adopted a CAP-introduced resolution to ensure pathology and lab referrals are made based on the physician's medical judgment for optimal patient care.

The impact: The resolution, which is now AMA policy, aims to stop health plan in-network steering of pathology and laboratory services. 

• In recent years, health plan payers are limiting lab referrals and patient access through steering and similar tactics in insurance products like Medicaid managed care health plans.
• They're enforcing policies that restrict physicians’ medical discretion, requiring physicians to refer to “preferred” in-network labs, sometimes only one designated lab.

The resolution says that the AMA will support state and federal efforts to prohibit steering by insurers. 

• It also says the AMA will advocate along with state medical and specialty societies to protect ordering physician discretion to refer specimens to any in-network pathology or lab provider.

Coalition effort: The CAP appreciates the collaboration and support of the members of the Pathology Section Council to get this issue raised at the AMA and AMA policy approved.

• The Pathology Section Council includes AMA HoD delegates and alternate delegates from the American Society of Cytopathology, American Society for Clinical Pathology, American Society of Dermatopathology, CAP, and National Association of Medical Examiners.

CAP at the AMA Meeting

The AMA hosts two meetings a year to debate and adopt policy. Its 2025 Interim Annual Meeting is taking place at National Harbor, Maryland, November 14–18.

Representing the CAP at the meeting were President Qihui "Jim" Zhai, MD, FCAP; President-Elect Kalisha Hill, MD, FCAP; delegates James L. Caruso, MD, FCAP, Joe Saad, MD, CPE, FCAP, Susan Strate, MD, FCAP, and Mark Synovec, MD, FCAP; and alternate delegates Diana Marcella Cardona, MD, FCAP, Jean Forsburg, MD, FCAP, and Joseph Sanfrancesco, MD, FCAP.

The CAP and Pathology Section Council secured another win at the AMA meeting with a resolution prohibiting deceptive ads and marketing by programs to train health professionals and other non-physicians. 

The impact: The resolution emphasizes the concept of "truth in advertising" for potential trainees of pathologist assistants so they clearly understand their scope of practice after completing their programs. 

• The resolution supports state and national medical societies' efforts to advance clarity and accountability in non-physicians’ scope of practice and training under a licensed practitioner. 

The resolution includes steps to ensure honesty in allied health educational programs, including:

• Stop programs from using misleading or false advertisements regarding professional job titles and the responsibilities of graduates.
• Ensure programs match state laws and recognized medical standards for training and certification for allied health professionals.
• Require advertising to clearly state the required level of physician supervision allowed for program graduates.

The Pathology Section Council collaborated to advance and support the passage of this resolution.

Congress passed a bill late last week to end the longest government shutdown in US history.

The legislation keeps the government funded until January 30, with votes to be held on several issues, including health care subsidies in the Affordable Care Act. 

What’s next for pathologists? Labs got a 30-day reprieve from January 1 cuts of up to 15% to tests on the Medicare clinical laboratory fee schedule. Congress still needs to find a long-term solution. 

• The CAP and the laboratory community are strongly lobbying lawmakers to pass the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act, to stop the 15% cuts and create a new method for calculating clinical lab fees.
• The CAP is also urging Congress to stop Medicare’s planned "efficiency adjustment" that cuts physician reimbursements by 2.5%. 

Act now: The CAP is continuing to advocate and engage with lawmakers to stop adverse cuts. Ready to take action? Keep the momentum going with these three steps.

• Contact your federal lawmakers and urge them to stop the Medicare payment cuts.
• Encourage lawmakers to support the RESULTS Act to fix these Medicare cuts permanently.
• Sign up for PathNET to stay informed about ongoing grassroots advocacy efforts.

The Association for Diagnostics and Laboratory Medicine (ADLM) has issued updated guidance on coagulation testing for patients using direct oral anticoagulants (DOACs).

Coagulation testing remains a critical tool for diagnosing bleeding and clotting disorders, guiding treatment decisions, and monitoring patient outcomes. With the growing range of anticoagulation therapies, DOACs have emerged as a convenient alternative to traditional blood thinners, offering effective management without the need for routine monitoring.

These new recommendations aim to help clinicians ensure that patients taking DOACs receive accurate test results, appropriate diagnoses, and optimal care.

Learn more: Read the updated guidance.

Next month, the CAP will host a webinar offering an in-depth look at the latest updates to the Medicare Physician Fee Schedule and the Quality Payment Program.

Event details: Hear from experts Joe Saad, MD, CPE, FCAP; Ronald W. McLawhon, MD, PhD, FCAP; and Gregary Bocsi, DO, FCAP, as they share key insights and practical guidance on these important changes.

Date & Time: December 5, 3:00 PM ET

Learn more: Read about the CAP’s advocacy efforts that advanced progress in protecting Medicare payments for pathologists.

Register Today

Are you ready to make meaningful change on behalf of your specialty? 

CAP members have the opportunity to join the House of Delegates (HOD), the CAP’s elected network of over 600 pathologists, representing every military branch and every state and region across the US and Canada. 

For more than six decades, the HOD has been a dynamic platform where members shape dialogue on the most pressing issues facing our specialty. Now is your chance to add your voice and represent your region!

As a delegate, you will:

• Amplify the voice of your region and share your perspective with CAP leadership.
• Communicate the needs and priorities of your colleagues.
• Influence timely conversations that affect practices and patients.
• Build your professional network and grow as a leader.

What's next: The self-nomination form to appear on your State/Region ballot is now open until January 18. Hundreds of CAP members have stepped forward to serve in the HOD. Will you be one of them? Your voice can make a difference. Submit your nomination today.

Nominate Yourself Now