Scheduled maintenance

Appeals Court Rules With Providers in No Surprises Act Case

08/19/2026
Podcast

August 19, 2026

CAP Test Ordering Program

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.