Previous Advocacy Updates

The CAP urged the CMS to provide regulatory relief on several issues that affect pathologists, including prior authorization, rural health care access, evaluation and management services, and timely regulation communication.

The CMS released the proposed 2020 Medicare physician fee schedule with some changes to the evaluation and management (E/M) payments. The CMS proposed an increase payment for E/M office visit services for primary care and decrease for all other specialty services and procedures, including pathology services.

A US Court of Appeals ruled in the CAP’s favor by reversing a lower court decision and stating that federal courts do have jurisdiction to decide the merits of a challenge to the federal government’s administration of PAMA.

The CMS proposed its 2020 Medicare Physician Fee Schedule and new rules for next year’s Merit-based Incentive Payment System (MIPS).

On July 25, CAP members will receive an email directing them to use a form letter to email their representatives and senators to advocate on out-of-network medical bills.

The CAP opposed the No Surprises Act because it fails to include an independent dispute resolution process that’s successfully proven to keep patients from receiving surprise medical bills.

The CAP supports the Protecting People from Surprise Medical Bills Act legislation, which has earned 40 cosponsors in the House.

Citing concerns over a payment formula that creates imbalance and threatens patient access to pathology services, the CAP opposed the out-of-network reimbursement provisions included in the latest Surprise Medical Billing legislation.

The CAP urged lawmakers to establish a fair arbitration process while holding patients harmless when physicians services are unexpectedly provided out of network.

The CAP led a delegation of pathologists at the 2019 American Medical Association Annual Meeting to set policy affecting the practice of medicine the weekend of June 8.

The CAP will lead a delegation of pathologists at the 2019 AMA annual meeting to set policy that affects the practice of medicine.

The CAP commended the Washington state law that will protect patients from surprise out-of-network medical bills.

The White House hosts event on Surprise Medical Bills and the CAP continues to advocate to protect patients.

CAP members made an impact on health policy by meeting with their federal legislators to advocate for patients and the pathology specialty in Washington, DC.

CAP members came to Washington, DC, to advocate how Medicare should reimburse clinical laboratory tests and to protect patients from surprise medical bills.

At the 2019 Policy Meeting, CAP members will go to Capitol Hill to advocate for policies that protect patients from surprise medical bills and ensure an accurate, market-based payment system for laboratories paid through the Medicare clinical laboratory fee schedule.

As part of legislation enacted in 2018 to address the opioid crisis, Congress included the Eliminating Kickbacks in Recovery Act in the final bill.

The CAP is concerned about inconsistent guidance from the National Correct Coding Initiative Policy Manual that affects payment for laboratory tests.

The CAP urged the CMS to change its NCD policy implementation on NGS for patients with advanced cancer and continues to engage with the CMS.

By using CAP-developed quality measures in 2017, the vast majority of pathologists stopped a 4% Medicare penalty and optimized their Merit-based Incentive Payment System (MIPS) scores to earn positive adjustments to their payments in 2019.