Read the Latest Issue of STATLINE

In This Issue:

The CAP continues to engage and advocates with other leading laboratory stakeholders regarding new clinical laboratory payment rates. On October 6, the CAP along with the American Clinical Laboratory Association, the National Independent Laboratory Association, Point of Care Testing Association, and AvaMedDX, sent a joint letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma to suspend implementation until the agency can address the significant deficiencies in its process to establish new clinical laboratory payment rates. On September 22, the CMS released the Clinical Laboratory Fee Schedule with significantly lower draft payment rates for lab tests under the Protecting Access to Medicare Act (PAMA). The CAP and other laboratory groups would like the CMS to address serious flaws in the PAMA data collection process, which results in unreliable draft payment rates.

As a service for CAP members, the CAP analyzed the impact of the top 100 Healthcare Common Procedure Code System (HCPCS) CLFS codes by volume, which represents 80% of total CLFS spending.

The coalition letter cites modifications to the PAMA regulation that must be addressed before stakeholders can support enactment. Specific concerns include data integrity, market representation of all segments of the laboratory market including national independent, community and rural independent, hospital outreach, and physician office laboratories, and the validation of data collected by the CMS.

The CAP will continue to engage other groups on this issue and will provide periodic updates.

Back to the top

In 2017, the CAP and its registry vendor partner FIGmd are offering pathologists free access to registry reporting to aim for a full bonus in Medicare's Merit-based Incentive Payment System (MIPS).

Pathologists can use the 2017 MIPS Reporting Solution to maximize their opportunity to increase their Medicare payment. There is no cost to report with the 2017 MIPS Reporting Solution.

With the 2017 MIPS Reporting Solution, pathologists can fully meet program requirements.

  • If you currently report quality measures through billing or other ways: Increase your bonus potential by attesting for the improvement activities.
  • If you have not decided how to report for MIPS 2017: Report on quality measures for a 90-day period–or a full year of patients—and attest to improvement activities to increase your payment potential and, at a minimum, avoid a payment penalty.

The 2017 MIPS Reporting Solution includes eight pathology-specific quality measures developed by the CAP and all 92 improvement activities included in the MIPS program. The CAP has identified a subset of the improvement activities that are most pertinent to pathologists (e.g. reports to referring physicians, maintenance of certification part IV, etc.)

Contact CAP registry staff if you have questions about the 2017 reporting option.

Back to the top

Thursday, November 9, 2017
12:00 PM CT

The CAP continues engage with the Centers for Medicare and Medicaid Services (CMS) to protect the value of pathology services for its members. Learn about the results of these advocacy efforts during this 60-minute webinar.

Experts from the CAP will review the final CMS 2018 Medicare Physician Fee Schedule, which includes Medicare reimbursement and policy changes that affect pathologists and their payments.

Learn from Donald Karcher, MD, FCAP, Chair of the CAP Council on Government and Public Affairs, W. Stephen Black-Schaffer, MD, FCAP, Chair of the CAP Economic Affairs Committee, and Jonathan Myles, MD, FCAP Board of Governors for the CAP on how the final the physician fee schedule will affect pathology services in 2018 and beyond. During the webinar presentation, CAP experts will review the CAP's advocacy efforts to impact final changes to the Physician Fee Schedule.

Register today.

Back to the top