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.