Advocacy Update

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October 27, 2020

In this Issue:

HHS Expands COVID-19 Relief Fund to Include Laboratories

The Department of Health and Human Services (HHS) announced that the Provider Relief Fund will now include laboratories as eligible providers who can apply for the federal pay program. On October 1, the HHS announced it would allow up to $20 billion in new funding for providers on the frontlines of the coronavirus pandemic. The HHS will update its most recent Provider Relief Fund reporting instructions to broaden the use of program. The CAP had urged Congress and the HHS to give pathologists and laboratories greater support through relief funds to pathologists. We have also encouraged pathologists to apply for these federal programs when eligible and have provided CAP members with resources for the program.

The HHS invited laboratories that already received relief fund payments to apply for additional funding “that considers changes in patient care operating revenue and expenses caused by the coronavirus.” The HHS also expanded the list of eligible applicants to providers who had not previously received fund payments. The newly eligible providers will receive “a baseline payment of approximately 2% of annual revenue from patient care plus an add-on payment that considers changes in operating revenues and expenses from patient care, including expenses incurred related to coronavirus.” All payment recipients must accept the associated terms and conditions.

The new eligible providers have until November 6 to apply for funds.

Reporting Requirements Update

The HHS amended the reporting instructions to include revenues attributable to coronavirus. After reimbursing health care-related expenses attributable to coronavirus, providers may use remaining funds to cover any lost revenue from patient care related sources.

The HHS has published several resources, and the CAP is here to help. A policy memorandum on the reporting requirement decision can be found here. The amended reporting requirements guidance can be found here. Provide us with your feedback and additional questions about these financial programs by emailing the CAP at

CAP Recommends Change to American Cancer Society Cervical Cancer Guideline

Citing access issues that lead to unscreened and under-screened women, the CAP urged the American Cancer Society to retain its guidelines on cytology and human papillomavirus co-testing as a screening strategy for adults as it provides the sensitivity and specificity needed for patients.

In July, the American Cancer Society updated its cervical cancer screening guidelines that underscored the importance of HPV platforms. However, the guidelines elicited significant concern with the endorsement of primary HPV testing as the preferred screening test for individuals with a cervix between 25 and 65. For example, after this change was announced, the American College of Obstetricians and Gynecologists affirmed current cervical cancer screening guidelines, encompassing all three cervical cancer screening strategies—high-risk HPV testing alone, cervical cytology alone, and co-testing.

Cervical cancer screening in the US is not performed through an organized national system. Many women are under-screened (or unscreened) with US HPV vaccination rates still lower than other developed countries, the CAP said in a letter on October 15. Thus, women in the US have less primary and secondary prevention of cervical cancer than countries with organized preventive services who have adopted primary HPV screening.

Studies from the Centers for Disease Control and Prevention show women of lower socioeconomic status are at higher risk of not being screened, along with several minority groups. If insurers no longer cover cervical cytology, the existing disparities in preventive services for women in the US are likely to increase.

Read the full letter from the CAP Arrow Right

Michigan Governor Signs CAP-MSP Amended Out-Of-Network Bill

On October 23, Michigan Gov. Gretchen Whitmer signed into law out-of-network billing legislation, which was successfully amended by the Michigan Society of Pathologists (MSP) and the Michigan State Medical Association. The new law protects patients from surprise medical bills while providing an out-of-network payment methodology that is the greater of 150% of Medicare, or the median in-network rate. Both the MSP and the CAP worked with the Michigan State Medical Society’s physician coalition to advocate for critical changes to the bill.

The MSP and the CAP worked together to amend out-of-network billing legislation (HB 4459) and (HB 4460), which passed the Michigan Legislature on October 13. While the law does not contain an arbitration mechanism for non-emergency services or health plan network adequacy advocated by pathology, both the MSP and the CAP are pleased with the Michigan law.

CAP COVID-19 Impact Survey Reveals Substantial Changes in Pathologists’ Work Hours

A recent survey conducted by the CAP Policy Roundtable revealed that the COVID-19 pandemic has had a substantial impact on many pathologists’ working hours.

Pathologists who are based in academic hospitals/medical centers are slightly more likely to have reported working more hours. By comparison, those based in non-academic hospitals and in independent laboratories are slightly more likely to have reported working fewer hours. Overall, 24% of respondents said they were working fewer hours than they were before the pandemic, while 20% said they were working more hours.

Among respondents who reported working more hours, the average increase in work hours was +11.9 hours, and the median increase was +10.0 hours.

The CAP surveyed board-certified pathologists nationwide, and 85% of respondents reported the COVID-19 pandemic has negatively affected pathologists.

Dr. Booth: How You Can Champion Health Policy with the CAP

Periodically, CAP Advocacy features one of the many CAP members who are champions for pathology through their advocacy at the federal or state level through our grassroots and programs. If you would like to get involved, you can join PathNET, contribute to PathPAC, or join your state pathology society.

Recently Advocacy Update caught up with Adam Booth, MD, who is the Immediate Past Chair of the Resident’s Forum of the CAP’s House of Delegates. Currently, Dr. Booth is fellow of Gastrointestinal and Hepatobiliary Pathology at Beth Israel Deaconess Medical Center in Boston. Dr. Booth knows that advocacy can shape health policy for pathologists.

What drove you to get involved in advocacy?

My first exposure to advocacy came early in training as a first-year resident at the University of Texas Medical Branch. Tim Allen, MD, FCAP, was my attending pathologist while serving on the CAP Board Governors and as President of the Texas Society of Pathologists (TSP). I attended the TSP Young Pathologists' Section Retreat early that year, and Dr. Allen spoke on medicolegal issues and the importance of advocacy for our profession. That set things in motion, and I was fortunate to become active in both the TSP and the CAP. I also interviewed Dr. Allen on how to advocate for our specialty.

Do you have a favorite memory or experience that stands out in your advocacy work?

Without a doubt, my favorite memory was attending the 2019 CAP Policy meeting (which will be the Pathologists Leadership Summit) in Washington, DC. Admittedly, I was anxious about speaking with federal legislators, but the meeting prepared me in advance, and I was joined by Texas CAP members with current CAP President-Elect Emily Volk, MD, FCAP; Leilani Valdes, MD, FCAP; Michael Deck, MD, FCAP; and Michele Hebert, MD, FCAP. It’s easy to be skeptical of the government in today's political atmosphere, but I genuinely felt heard and represented after visiting the legislative offices.

What advice would you give to your colleagues in order to be effective advocates?

Be proud to be a pathologist! Take advantage of opportunities to share the critical role of pathology and laboratory medicine in patient care. Try to relate an aspect of pathology to the listener. Suppose I’m speaking to a patient, representative, or non-medical individual. In that case, I describe SARS-CoV-2 testing, a screening colonoscopy, or a related companion diagnostic test for a drug commercial they saw on television. When talking to medical students, I ask what specialty they're planning to enter then relate that back to pathology. For example, for a future gynecologist, I’ll describe our role in intraoperative consultation to stage gynecologic cancers and encourage them to follow the specimen to the laboratory sometime.

How was your experience meeting with your member of Congress for the Fight the Cuts campaign? Is there any advice you have for your colleagues?

CAP Advocacy recently coordinated an opportunity for me to speak with Rep. Ayanna Pressley’s (D-MA) Health Care Legislative Assistant. On the call, I was able to stress the negative impacts our patients could face should the cuts take effect. Payment cuts can lead to slow turnaround times, staff reduction, and laboratory closures, creating preventable access to care situations. Amid COVID-19, we need laboratories functioning at full capacity to serve our patients and provide the best care possible.

Last Week to Test Your October Advocacy Knowledge

It’s the last week to test your October Advocacy knowledge with this month’s Advocacy news quiz. See how you compare against your fellow CAP members’ by taking this month’s quiz and share it on social media.

Take the October news quiz Arrow Right