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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 April-June 2020.

In this Issue:

CAP Advocates for COVID-19 Diagnostic Test Payment Increase

In its advocacy to protect the value of pathology services, the CAP has sought to ensure that laboratories are compensated fairly for COVID-19 tests. On June 22, the CAP engaged with the Centers for Medicare & Medicaid (CMS) to urge the agency to increase payment for the CPT code 87635.

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CDC Guidance on COVID-19 Serology Testing Follows Statements by CAP, AMA

The Centers for Disease Control & Prevention (CDC) released interim guidelines on the use of COVID-19 antibody tests in clinical and public health laboratories. The CDC interim guidelines followed a statement by the CAP articulating concerns about serology testing.

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Second Survey Confirms Laboratories Have More COVID-19 Testing Capability Despite Challenges

To effectively lobby on behalf of pathologists and the laboratories they lead, the CAP surveyed the directors of accredited laboratories nationwide regarding the rate of COVID-19 testing, critical barriers to expanding testing, and the financial impact of the pandemic on pathologists. In May, the CAP first published results confirming that while clinical laboratories are expanding testing and over 60% of laboratory directors report difficulties in obtaining critical supplies needed for tests. The CAP resurveyed laboratories in June to provide decisionmakers with more information about trends for testing.

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Laboratory Inspections Suspended For Duration of Pandemic Because of CAP Advocacy

EDITOR’S NOTE: Information in this article has changed since its publication in April. For the most current information for laboratories and inspections, visit our COVID-19 recent updates page.

Because of the unique challenges facing pathologists and laboratories during this unprecedented national emergency, the CAP strongly advocated to reduce burdens on laboratories and pathologists. For instance, the CAP asked the CMS to extend the suspension of laboratory inspections. The CMS agreed with the CAP’s request and will suspend CLIA laboratory inspections for the pandemic duration.

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CAP Launches Summer Advocacy Campaign to Stop Medicare Cuts

The CAP is mobilizing pathologists for political action through a summer campaign of virtual advocacy demanding that Congress delay, mitigate, or cancel the 8% Medicare cut for pathology services that will take effect on January 2021. The CAP is working to amplify pathologists voices in Washington, DC, so Congress hears about the severe impact this -8% cut will have on our specialty.

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Paycheck Protection Program Flexibility Legislation Passes in Congress

On June 5, President Donald J. Trump signed into law CAP–backed legislation that increases flexibility in the Paycheck Protection Program for small businesses like pathology practices. The CAP supported the bill because of the additional flexibilities and modifications for those securing loans during the economic downturn. New provisions include an easier process to qualify for loan forgiveness.

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CAP Engages with Congress on Next Iteration of ‘Cures 2.0’ Landmark Legislation

The CAP emphasized its priorities regarding national testing and response strategy for future pandemics in a May 11 letter to congressional lawmakers. The CAP has discussed the pathologists’ primary issues with the decision makers on Capitol Hill who have developed a foundation for legislation focused on diagnostics, medical research, and new treatments.

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CAP Objects to UnitedHealthcare Fee Schedule Cuts in Texas

In its advocacy with private health insurance plans, the CAP champions policies protecting access to pathology services. In response to reports of new fee schedules in Texas by the health plan UnitedHealthcare that could lower payment rates for pathology services, the CAP will strongly object and urge the insurer to reverse the cuts.

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CAP Calls on Anthem to Stop Cuts to Pathologists

The CAP urged Anthem BlueCross and BlueShield (BCBS) to stop its implementation of the 2019 fee schedule cuts as well as reinstate payments to previous levels where the cuts were implemented. The CAP stressed our longstanding policy that the professional services of the pathologist must be recognized.

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With Georgia Pathologists and CAP, State Legislature Passes Out-of-Network Legislation

A multi-specialty coalition, expertly led by the Medical Association of Georgia (MAG), in which both the Georgia Association of Pathologists (GAP) and the CAP were integrally involved, approved of out-of-network legislation that is poised to become law soon.

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Tennessee Suspends Lab Inspections, Allows for Remote Work

Tennessee Gov. Bill Lee issued an executive order on May 12 that would suspend state and medical laboratory inspections and allow laboratory directors and laboratory staff to work remotely when possible, an issue that the CAP has fought for during the pandemic.

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Ohio Pathologists, CAP Oppose Out-Of-Network Legislation

The Ohio Society of Pathologists (OSP), the Ohio State Medical Association (OSMA), and the CAP strongly oppose to House Bill 388, a measure designed to address out-of-network billing, but which the groups say will unfairly punish out-of-network physicians.

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CT Governor Rescinds Order that Would Have Lowered Pay to Physicians

Because of CAP’s advocacy, the governor of Connecticut rescinded part of a recently issued executive order that would have reduced payment to out-of-network physicians providing emergency services.

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Virginia’s Governor Signs Historic Surprise Billing Legislation Championed by VSP, CAP

In a major win for the Virginia Society for Pathology and the CAP, Virginia Gov. Ralph Northam signed legislation backed by physicians to protect patients from surprise medical bills and ensure out-of-network care is reimbursed at reasonable rates.

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Over 1,000 CAP Members Successfully Submit MIPS Data, Will Earn Bonuses with Pathologists Quality Registry

More than 1,000 pathologists from nearly 100 practices completed their 2019 performance year reporting for Medicare’s Merit-based Incentive Payment System (MIPS) by utilizing the Pathologists Quality Registry and its top-tier staff expertise.

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CAP, AMA Fight to Protect Physician Scope of Practice

The AMA, the CAP, and several other medical societies asked the CMS to reconsider changes to the scope of practice provisions in the proposed 2021 Inpatient Rehabilitation Facility Prospective Payment System regulation.

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CAP Leads Efforts for Critical Coverage of Respiratory Viral Panel Tests

The CAP, the Association for Molecular Pathology and the Infectious Diseases Society of America, urged for coverage of respiratory viral panels during the COVID-19 pandemic.

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2020 Medicare Payment for Pathologists Webinar

The CMS will issue its proposed updates to the 2021 Medicare Physician Fee Schedule and the Quality Payment Program regulations, including the Merit-based Incentive Payment System (MIPS). On August 5 at 1 PM ET/ 12 PM CT, the CAP will offer a complimentary live webinar where CAP experts will review regulatory changes that will impact pathologists’ payment for services in 2021.

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Latest CAP Updates on COVID-19

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CAP Advocacy Twitter

Want up to the minute CAP Advocacy news? Then follow us on twitter @CAPDCAdvocacy, where you will be the first to know about CAP Advocacy wins, see your fellow members engage with congressional leaders on key policies affecting the practice of pathology and, of course, breaking Advocacy news.

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