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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 October-December 2022

In this Issue:

Congress Addresses Key CAP Priorities in Omnibus Bill

In its 2023 federal funding legislation, Congress mitigated next year’s scheduled Medicare cuts to physicians, delayed implementation of pending cuts to clinical laboratory fees, and included a bill championed by the CAP to ensure the nation is prepared for future pandemics. Read more

CAP Lays Out its Priorities for Congress to Act on Before 2023

As Congress debated its year-end legislation for 2022, the CAP laid out its priorities, such as stopping Medicare cuts to pathologists and laboratories, for inclusion in the year-end omnibus appropriations package. Read more

CAP Engages with Lawmakers on VALID Act as Compromise on Exemption for AMCs is Considered

The CAP stayed engaged with members of Congress as they considered changes to the VALID Act. The Senate Health, Education, Labor, and Pensions (HELP) Committee released a modified draft of the legislation that included an exemption for laboratories operating at an academic medical center (AMC). Read more

AMA, CAP Urge Congress to Oppose Legislation that Endangers Patients’ Health Care Quality

The American Medical Association (AMA), the CAP, and over 80 other professional medical groups urged Congress to oppose legislation that would endanger health care quality by expanding the scope of practice of nonphysician practitioners. The coalition asked congressional leaders to oppose the Improving Care and Access to Nurses (I CAN) Act, as it would expand the medical scope of practice for nonphysician practitioners. The CAP advocates to protect pathologists’ scope of practice from encroachment by nonphysician groups. Read more

CAP and Coalition of Medical Groups Support Senate Effort to Stop Medicare Pay Cuts in 2023

The CAP and a coalition of medical professional organizations have asked Senators to sign a letter as a strong show of support to prevent 2023 Medicare cuts from going into effect. The November 1 letter urged Senate Majority Leader Chuck Schumer (D-NY) and the Senate Minority Leader Mitch McConnell (R-KY) to work on a bipartisan basis to address these imminent payment cuts. Read more

CAP Provides MACRA Improvement Recommendations to Congress

The CAP provided Congress with recommendations to improve Medicare’s payment program on October 31. In response to a congressional request for information regarding the potential reform of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the CAP provided feedback regarding pathologists’ experience in dealing with the current payment program and potential actions Congress could take to stabilize the Medicare payment system by reforming MACRA. Read more

In CAP Advocacy Win CMS Finalizes Increase to Pathology Clinical Labor Rates in 2023

In an advocacy win for the pathologists, the CMS finalized the proper rank order of the clinical labor rates for histotechnologists and laboratory technicians in the final 2023 Medicare Physician Fee Schedule (PFS). Because of the CAP’s advocacy, there will be more accurate payments for pathology services in 2023. Read more

CMS Further Delays Enforcement of Good Faith Estimate Requirements

On December 2, the Centers for Medicare & Medicaid Services (CMS) published an FAQ announcing that the agency further delayed enforcement of the good faith estimate (GFE) requirements for uninsured or self-pay individuals. The FAQ clarified that the Department of Health and Human Services (HHS) is extending enforcement discretion, pending future rulemaking, for situations where GFEs for uninsured (or self-pay) individuals do not include expected charges from co-providers or co-facilities. According to the HHS, they have received feedback that “compliance with this provision is likely not possible by January 1, 2023, given the complexities involved.” Read more

CAP Wants Reduced Burden and Adds Safeguards in Upcoming Good Faith Estimates Regulations

The CAP asked the Biden administration to consider the burden and potential misuse of data by insurers in comments regarding upcoming good faith estimates (GFE) regulations. The new regulations, which have not yet been released, would implement requirements around an “advanced explanation of benefits” and additional GFE requirements of the No Surprises Act. Read more

CAP Urges CMS to Streamline Medicaid, CHIP to Improve Health Care Equity and Reduce Burden

The CAP urged the CMS to reduce the administrative burden for physicians and patients in Medicaid and the Children’s Health Insurance Program (CHIP) to health equity in both programs. As physicians and stewards of laboratory medicine, the CAP and its members are committed to achieving health equity and addressing health care disparities to ensure quality, accessible patient care. Read more

CAP Asks CMS to Examine Remote Work Practices After Emergency Declaration Ends

The CAP recently asked the CMS to evaluate remote sign-out practices for pathologists after the public health emergency ends. Read more

CAP Tells Highmark to Abandon Third Party Validation for NGS Testing

The CAP strongly opposed the health insurer Highmark’s new credentialing requirements for next-generation sequencing (NGS) testing that imposes independent third-party validation of NGS results and/or variants of uncertain significance interpretation. The CAP is concerned with the burdens placed on NGS testing laboratories to require meritless new credentialing requirements. Read more

New Monkeypox Test Code Mapping Guide; HHS Extends Public Health Emergency

The Centers for Disease Control and Prevention (CDC) announced a new test code mapping guide for monkeypox on November 14. The LOINC In-Vitro Diagnostic (LIVD) Test Code Mapping Guide is available for all monkeypox virus diagnostic tests that received Food and Drug Administration (FDA) Emergency Use Authorization. This guide supports the use of harmonized LOINC and SNOMED Clinical Terms (CT) codes to help improve the accuracy and standardization of monkeypox virus test reporting across the United States. Read more

New Jersey Pathologists Advocates for Network Adequacy

On October 13, the New Jersey Society of Pathologists (NJSP), with CAP support, urged the adoption of health plan network adequacy amendments to A 4485, which include provisions applicable to hospital and facility-based physician specialists, including pathology before the New Jersey Assembly Financial Institutions and Insurance Committee. The CAP worked closely with the physician coalition and the New Jersey Medical Society to secure network adequacy requirements for hospital and facility-based physicians. Read more

CAP Urges District of Columbia Council to Reexamine Laboratory Personnel Licensure Law

On September 28, CAP President-elect Donald Karcher, MD, FCAP, urged in public testimony to the Council of the District of Columbia (DC) to reconsider laboratory personnel licensure and additional statutory fixes in lieu of repeal within the personnel clean-up bill B24-764 proposed by the Mayor’s office. The law was initially enacted in 2015 but never operationally implemented. At this stage, the DC Council appears to be carefully weighing the concerns expressed by CAP and other stakeholders, including the DC Hospital Association (DCHA). Read more