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Quarterly Advocacy Update

Keeping you informed on policy issues affecting pathology and laboratory medicine.

Recap of the Latest Advocacy News from July-September 2020.

In this Issue:

CAP Convinces HHS to Make Substantial Changes to its COVID-19 Lab Reporting Rules

The HHS responded to the CAP’s advocacy by giving laboratories additional flexibility to meet new COVID-19 data reporting requirements during the current pandemic. The HHS will only penalize laboratories for failing to report positive or negative test results and laboratories would further receive a three-week grace period to meet new rules.

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CAP Asks CMS to Increase Payment for COVID-19 Testing

The CAP has sought to ensure that laboratories are compensated adequately for COVID-19 tests throughout the pandemic. The CAP again urged the Centers for Medicare & Medicaid Services (CMS) to increase their COVID-19 payment rates nationally.

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CAP Advocates to Address Testing Supply Shortages

CAP President Patrick Godbey, MD, FCAP, spoke directly with officials from the Centers for Disease Control and Prevention (CDC) about persistent laboratory supply shortages. And, in a letter to Vice President Mike Pence, the CAP partnered with the laboratory community to offer solutions to overcome obstacles to performing diagnostic tests for COVID-19.

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CAP Advocacy in Action: CDC Reverses COVID-19 Testing Guidance

The CDC reversed guidance criticized by the medical and scientific community, including the CAP, about who should be tested for COVID-19. The CDC updated its recommendation to include testing asymptomatic patients who have been in close contact with someone diagnosed with COVID-19.

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160 House Lawmakers Tell CMS to Stop Medicare Cuts to Pathologists

By mobilizing pathologists for political action and direct lobbying with members of Congress, the CAP worked to secure congressional support for stopping Medicare cuts to pathologists next year. A bipartisan coalition of more than 160 members of Congress have urged federal health officials to mitigate these cuts to pathologists and other specialists set to take effect in 2021.

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CAP, AMA Demands Congress Protect International Medical Graduates During COVID-19

The CAP called on congressional leaders to act, and not limit access to the physician workforce through immigration restriction during a national health crisis. In a July 10 letter to congressional leadership, the CAP urged lawmakers to reverse a proclamation curbing immigration visas for international medical graduates through the end of 2020.

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Congress Avoids Government Shutdown, Extends Medicare Loan Program Repayment

Congress passed a CAP-backed bill, with some notable changes to the Medicare Accelerated and Advance Payment program, that will fund the government until December 11. Due to the pandemic's economic effects on pathologists and laboratories, the CAP had urged Congress to make several changes to the Medicare program, including extending the repayment deadline for participants.

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CAP: UnitedHealthcare Should Stop Cuts to Pathologists

In its advocacy with private health insurance plans, the CAP champions policies protecting access to pathology services for patients, and protecting against taxing pathologists with administrative burdens. With the COVID-19 pandemic causing great financial strains on pathologists and their laboratories, the CAP urged UnitedHealthcare to cease implementation of fee schedule cuts, or reverse cuts that are already in effect, to pathologists practicing in Texas.

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CAP Objects to UnitedHealthcare’s Test Registration, Requests Meeting

The CAP objected to UnitedHealthcare’s latest requirement that laboratories register most diagnostic tests and requested a meeting with the insurer to discuss the issue. The CAP is engaged on the new reimbursement policy and on August 26, 2020, sent a letter to UnitedHealthcare’s leadership with its concerns.

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Florida Pathologists Reverse Hostile Medicaid Proposal

Under pressure from the Florida Society of Pathologists (FSP), with lobbying support from the CAP, the Florida Agency for Health Care Administration (AHCA) reversed its proposed Medicaid policy to eliminate professional component reimbursement for clinical laboratory services across an array of approximately 1,000 clinical laboratory (CPT) codes.

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Pennsylvania Pathologists, CAP Seek Changes to Balance Billing Legislation

In a coordinated effort to protect patient access to medical services, the Pennsylvania Association of Pathologists (PAP) and the CAP joined a state provider coalition to oppose adverse legislation.

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Michigan Pathologists, CAP Call for Amendments to State Surprise Bill Legislation

The Michigan Society of Pathologists (MSP) and the CAP called for changes to state legislation that fails to effectively protect patients from surprise medical bills.

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Medicare Finalizes Proposal for Pathology Services in 2021, CAP Advocating to Stop the Cuts

The CAP provided its members with a detailed payment impact table and webinar program with our latest analysis of the proposed 2021 Medicare Physician Fee Schedule. As was expected, the CMS will follow through with significant payment cuts to pathologists and other specialists in 2021. The CAP is leading an aggressive campaign to stop these cuts from going into effect next year.

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CAP Advocacy Win: CMS Increased Payment to Hospitals for CAR T-Cell Therapies

Because of CAP advocacy, the CMS increased Medicare payments to hospitals that administer chimeric antigen receptor (CAR) T-cell treatments. The CAP asked the CMS to reconsider its payment methodology and increase the hospital reimbursement for CAR-T cell therapies for inpatient services.

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CMS Asks CAP for NGS-Data Personnel Guidance

After the CMS sought the CAP’s advice and guidance on laboratory personnel and the retention of Next Generation Sequencing (NGS) data, the CAP provided recommendations and plans ongoing discussions about qualified laboratory personnel requirements.

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