August 19, 2026
Transcript
Nick Lanyi
A No Surprises Act ruling hands providers a win, an incentive for recruiting new CAP members, and how best to test for vitamin B12 and folate deficiencies. These stories and more coming up next. This is Path News Network Daily Edition from the College of American Pathologists. I'm Nick Lanyi. It's Wednesday, August 19th. A federal appeals court last week sided with providers over insurers in striking down a formula used to calculate payment amounts under the No Surprises Act. The law, enacted in 2020 to protect consumers from unexpectedly high medical bills, also created an arbitration process for disputes between providers and insurers that has proved contentious. Last week's ruling involved the qualifying payment amount, which is used to resolve fights over out-of-network charges. The court ruled that the federal government's rules for calculating the QPA were too favorable toward insurers, resulting in unrealistically low payment amounts. The federal government has not said whether it will appeal to the U.S. Supreme Court. By asking colleagues to join the CAP, you can now get more than their everlasting thanks. If you know of a pathologist who isn't a member, share what the association offers. If the referred pathologist becomes a member, you'll both be rewarded with a $100 discount on membership dues. The more pathologists join the CAP, the more effective the association can be in promoting the specialty. Visit the member referral program page on Path Together to learn more. Clinicians commonly order tests for vitamin B12 and folate deficiencies to evaluate patients that may have anemia or neuropsychiatric problems. It's a test that's often overused, as signs and symptoms of B12 and folate deficiencies overlap with many other illnesses. Dr. Chuck Eby is the author of the CAP's test ordering module for vitamin B12 and folate deficiencies. He says pathologists can help avoid unnecessary testing by reviewing peripheral blood smears and recommending and interpreting additional tests. For one thing, vitamin B12 deficiency is more common than folate deficiency.
Dr. Chuck Eby
Folate, again, is an essential vitamin that we rely on our diet for, but it is extremely, extremely difficult to have a folate deficient diet. It creeps in in almost every every place that we eat. And so there has been a I think a good strong evidence that folate deficiency is actually much, much, much rarer than uh we are many many physicians perhaps suspect. And that the vast, vast majority of folate tests, which are usually done in combination with the B12, are normal and uh are not really necessary to investigate the underlying anemia.
Nick Lanyi
The CAP's testing module is one of many in its test ordering program, which provides information about commonly misapplied lab tests. Dr. Eby, professor emeritus of pathology at Washington University in St. Louis, says the modules can help pathologists be smart stewards of tests when the need isn't clear.
Dr. Chuck Eby
A fair number of people will have what we call kind of borderline B12 levels. They may be right near the lower limit of the hospital's of the laboratory's reference range. They may even dip a little bit below that reference range. But does that truly represent a functional deficiency of B12 in that individual? And for that, we do have some additional testing that can be very helpful.
Nick Lanyi
Learn more about this and other expert-led testing module at the test ordering program tab on the CAP's Laboratory Quality Solutions page. And on the way out, here's one for the annals of forensic pathology. Earlier this month, police in New South Wales, Australia responded to a call that someone had found human remains inside a suitcase. The police promptly sent it off to the autopsy lab. It was only there that forensic examiners discovered the alleged victim was actually a lifelike sex doll. Officials later said the person who called in the discovery did the right thing. It is a bad idea to examine a potential murder victim too closely. So the coroner was indeed the right one to determine that there was, well, no cause of death. That's all for today. Check the show notes for more information on today's stories, and spread the word about the Daily Edition by sharing a link with your colleagues. We'll be back at 5 a.m. Eastern Thursday for another episode of the Daily Edition. I'm Nick Lanyi. Have a wonderful day.