Previous Advocacy Updates

On September 13, Sens. Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), and Ron Johnson (R-WI) released an updated legislative proposal to repeal and replace portions of the Affordable Care Act (ACA). The new bill would roll federal funding for the ACA’s premium subsidies and Medicaid expansion into a single pool, and then convert it into block grants to the states. The legislation would also convert federal Medicaid funding to a per capita allotment and limit growth of federal Medicaid spending starting in 2020.

The Medicare program published the 2018 clinical laboratory fee schedule utilizing a new methodology based on private payer rates for tests collected from a small segment of providers. The CAP has called this collection process flawed and continued to urge the Centers for Medicare & Medicaid Services to delay of the implementation of the new fee schedule.

CAP Advocacy consistently works with Medicare officials to help ease the negative effects of the evolving Quality Payment Program (QPP) reporting requirements for pathologists and laboratories. Through a strategy developed by the Council on Government and Professional Affairs and Economic Affairs Committee, the CAP advocates to ensure pathologists can participate in the Quality Payment Program by providing resources to its members as the Centers for Medicare & Medicaid Services begins implementation of payment reforms in 2017.

The CAP advocated for the Centers for Medicare & Medicaid Services (CMS) to accept all the physician work recommendations for pathology services used to calculate professional component and global payment rates in the proposed 2018 Medicare Physician Fee Schedule, which was released in July.

The CAP advocated for reducing regulatory burdens on pathologists participating in the Medicare Merit-based Incentive Payment System (MIPS) and ensuring pathologists are fairly compensated in MIPS.

The CAP and other members of the Coalition of Hospital-Based Physicians are urging the Maryland Insurance Department to amend a proposed network adequacy rule to ensure it includes critical hospital-based physician specialties.

The CAP's state advocacy efforts help to secure the Centers for Medicare and Medicaid Services (CMS) requirement for insurers who participate in federally-facilitated health insurance exchanges to document their process for monitoring access to hospital-based physicians, including pathologists, at in-network hospitals.

The Centers for Medicare and Medicaid Services (CMS) announced that some clinicians may be exempt from participating in the Quality Payment Program through a Special Status calculation, including non-patient facing and hospital-based clinicians. The CAP had strongly advocated for this exemption to ensure flexibility for pathologists to participate in the program.

Registration is now open for key CAP policy and advocacy courses and roundtable discussions important to the pathology specialty during CAP17 at the Gaylord National Harbor from October 8–11, 2017.

On July 13, the Centers for Medicare & Medicaid Services’ released the proposed 2018 Medicare Physician Fee Schedule which reflected the CAP’s recommendations from the CAP and AMA Specialty Society Relative Value Scale Update Committee for physician work relative values to certain pathology services. Some of these recommendations reflected increases from current values.

In the Centers for Medicare & Medicaid Services’ (CMS) proposed 2018 Medicare Physician Fee Schedule released July 13, the agency proposed to accept all of the recommendations from the CAP and AMA Specialty Society’s Relative Value Update Society’s for physician work relative values to certain pathology services. Some of these recommendations reflected increases from current values.

On June 22, the Senate released its version of the American Health Care Act renamed the bill the Better Care Reconciliation Act of 2017 that would reform the nation's current Medicaid program, make significant changes to Affordable Care Act's (ACA) insurance regulations and coverage mandates, and eliminate the majority of the ACA taxes.

On June 22, the Senate released its version of the American Health Care Act renamed the bill the Better Care Reconciliation Act of 2017 that would reform the nation's current Medicaid program, make significant changes to Affordable Care Act's (ACA) insurance regulations and coverage mandates, and eliminate the majority of the ACA taxes.

The American Medical Association (AMA) is working with physician organizations like the CAP to tackle issues from health care reform to the network adequacy. A delegation of pathologists, led by the CAP, participated during the June 10 -14 AMA House of Delegates meeting, and advocated on behalf of laboratory medicine. During the meeting physicians voted Barbara L. Mc McAneny, MD, an oncologist from Albuquerque, N.M., as the new president-elect of the AMA. Following a year-long term as president-elect, Dr. McAneny will assume the office of AMA president in June 2018.

On June 20, the Centers for Medicare & Medicaid Services (CMS) published its proposed 2018 Quality Payment Program (QPP) established under the Medicare Access and CHIP Reauthorization Act (MACRA) that proposes reduced burdens and increased flexibility for physician quality reporting.

The Pennsylvania Association of Pathologists (PAP) and the CAP are strongly urging state lawmakers not to pass legislation to prohibit balance billing of patients by out-of-network (OON) providers, arguing that the measure is flawed in a number of ways.

On May 12 the Centers for Medicare & Medicaid Services (CMS) approved the Pathologists Quality Registry as a Qualified Clinical Data Registry (QCDR), making it an invaluable reporting option for pathologists with fulfilling reporting requirements under Medicare's Quality Payment Program (QPP). The Pathologists Quality Registry is the first pathologist-specific clinical data registry designed by pathologists to earn QCDR status from the CMS.

On May 16, the CAP Advocacy team and members of the Council on Government and Professional Affairs (CGPA) met with Health and Human Services Secretary Tom Price to discuss reducing regulatory burdens on Pathologists.

On May 9, the Senate—by a 57-42 vote, confirmed Scott Gottlieb, MD—as Commissioner of the Food and Drug Administration (FDA). As FDA commissioner, Dr. Gottlieb will oversee an agency with regulatory influence over pharmaceuticals and medical devices, in addition to food safety and other areas of human health.

The Centers for Medicare & Medicaid Services (CMS) approved the Pathologists Quality Registry as a Qualified Clinical Data Registry (QCDR), making it an invaluable reporting option for pathologists with fulfilling reporting requirements under Medicare’s Quality Payment Program (QPP). The Pathologists Quality Registry is the first pathologist-specific clinical data registry designed by pathologists to earn QCDR status from the CMS.