Read the Latest Issue of STATLINE
September 27, 2016
Senators Propose Transparency Reforms to Improve Medicare LCD Process
On September 22, the CAP welcomed the introduction of Senate bill 3392, the Local Coverage Determination Clarification Act, which would improve transparency and accountability when Medicare contractors set local coverage determination (LCD) policies for physician services provided to Medicare beneficiaries.
The Senate bill is sponsored by Sen. Johnny Isakson (R-GA) and Sen. Tom Carper (D-DE), and contains the same reforms that were introduced in the House in July. CAP President Richard C. Friedberg, MD, PhD, applauded and thanked the senators for introducing this important piece of legislation.
"Reforms in this legislation would ensure that Medicare local coverage determinations do not override physician medical judgment and deny patients access to medically necessary care," Dr. Friedberg said. "The Senate bill, along with companion legislation introduced in the House (HR 5721), would ensure that coverage decisions are made by qualified, independent health experts through a transparent process that is based on sound medical evidence."
The CAP supports principles contained in the legislation to improve the LCD process, which are:
- Open Medicare contractor committee meetings on LCDs
- Upfront disclosure of evidence considered during the drafting of an LCD
- Meaningful reconsideration and options to appeal LCDs
- Stopping the use of LCDs as a backdoor to National Coverage Determinations (NCDs)
CAP members can take action and encourage their elected officials to co-sponsor the legislation by sending them an email today. Visit the CAP's Action Center to engage with your representative or senator.
Just Released: Download the Results to the CAP's 2016 Practice Leader Survey
On September 26, the CAP published the results of the 2016 Practice Leader Survey and discussed the survey's findings at CAP16 in Las Vegas.
As a benefit of CAP membership, members can access and download the new report with the results of the survey fielded in March and April of 2016. The survey targeted practice leaders—those in leadership or administrative roles with specific knowledge of the practice's financial, operational, and billing information. The survey itself was designed to elicit one response from each pathology practice in the United States.
All survey responses are kept strictly confidential and reported in aggregate. The report is divided into six sections:
- Practice Demographics
- Services Provided by Pathology Practices
- Sources of Practice Cases and Revenues
- Practice Staffing
- The Pathologist Job Market
- Business, Regulatory, and Legislative Issues Affecting Pathology Practices
For specific questions on the survey report, please email firstname.lastname@example.org.
California to Require Electronic Reporting of Cancer Diagnoses
A new law in California will require pathologists to electronically report cancer diagnoses to the State Department of Public Health and recognizes the CAP electronic Cancer Checklists (eCC) as a method for reporting.
California Governor Jerry Brown signed the bill, AB 2325, into law on September 14. In 2019, pathologists would be required to submit cancer diagnoses to the Department of Public Health California Cancer Registry using the CAP eCC or other standardized format approved by the department.
If a pathologist does not use eCC, the bill allows pathologists to submit data from an electronic medical record or web portal. If the pathologist does not use an electronic system, the department is authorized to access the information in an alternative format. The law requires the pathologist to reimburse the department for the cost of accessing and reporting the information.
The California Cancer Registry collects statewide data, conducts surveillance, researches causes and cures for cancer, and communicates results to the public. In 2014, the CAP collaborated with the department and hospitals in California to pilot a system that collects and sends structured pathology cancer data to the registry using eCC.