Pushing for Medicare Clinical Laboratory Payment Reform

Nick Lanyi
0:02

Clinical Laboratory advocates lobby for Medicare reform. The AMA weighs in on AI in clinical settings. And new findings could improve DNA sequencing in cancer research. These stories and more coming up next. Welcome to CAP News. I'm Nick Lanyi with the College of American Pathologists. It's Tuesday, October 27th. Here's what's making news in pathology and laboratory medicine. The CAP joined several other medical associations last week to lobby for reform of the Medicare rate adjustments for clinical laboratory tests. Representatives of the Clinical Laboratory Coalition visited the offices of 13 House members and two senators on October 20th to lobby for the so-called RESULTS Act, which is short for Reforming and Enhancing Sustainable Updates to Laboratory Testing Services. Under the proposed rate system for 2027, reimbursements could drop up to 15% for some tests. The bill would require the Centers for Medicare and Medicaid Services to use an independent claims database for many widely available tests and reduce reporting burdens. It would also prevent cuts through 2028 and limit any annual reductions to 5% beginning in 2029. The group asked members to co-sponsor the bill and push for its passage by the end of 2026. You can join the effort by visiting the Action Center on the CAP website's advocacy page. The American Medical Association proposed an approach to govern the use of agentic AI for clinical functions. The framework comes as AI systems are increasingly capable of performing clinical functions, including diagnosis and treatment recommendations. The AMA said physicians should work with the AI industry and regulators to develop products and policies that enhance medical care while maintaining human oversight for safe use. The AMA said its fundamental principle for AI is that, quote, clinical authority should be earned through evidence and maintained through demonstrated performance, end quote. The AMA said it will produce more detailed frameworks addressing liability, licensure, and regulation by the end of the year. The Transactional Diagnostics Grant provides a four-week training next year at Ventana Medical Systems in Tucson, Arizona, working with the company's senior director of pathology on innovative histopathology-based assays. The award covers up to $5,000 to support travel and living expenses. Applicants must be currently enrolled in a pathology residency program with at least one year of residency completed. The application deadline is November 2nd. Go to the CAP Foundation website for more information. And finally, a new method of DNA sequencing is shedding light on the causes of some cancers. In a study published last month in the journal Cancer Discovery, researchers at the University of Michigan reported using so-called long-read DNA sequencing to identify hidden gene mutations in cancer cases that would otherwise be unexplained. Long-read sequencing analyzes thousands or even tens of thousands of DNA letters in a single stretch of DNA, versus only a few hundred in conventional short-read sequencing. In one part of the study, the researchers screened 768 patients with prostate, breast, or ovarian cancer. They found 46 tumors with suspicious genomic instability for which short-term sequencing could not find a cause. Using long-read sequencing resolved 32 of those 46 cases. The study's authors said long-read sequencing may help direct the best treatment for specific types of cancers. It could also help identify inherited cancer risk that conventional testing misses.org. We'll be back Wednesday at 5 AM Eastern with another edition of CAP News. I'm Nick Lanyi. Have a wonderful day.