Previous Advocacy Updates

Special Issue: The Food and Drug Administration released the final regulation on the oversight of laboratory-developed tests with some changes advocated for by the CAP. The CAP had opposed the regulation as written and called for several improvements that would ensure patient access to testing and allow for the continued innovation of new tests.

On April 16, CAP members met with their federal lawmakers and advocated to protect the value of pathology services. Pathologists discussed how Congress can mitigate Medicare payment cuts to physicians, set limits on future clinical laboratory fee cuts, and increase the medical workforce to address current shortages during meetings with 172 offices in the Senate and House of Representatives.

To prepare for the CAP’s annual Hill Day, CAP members discussed strategies for how they will engage their members of Congress at the Pathologists Leadership Summit on April 13-16. CAP Advocacy leaders prepared pathologists to lobby Congress on three main policies affecting the specialty: A long-term fix for Medicare cuts to pathology services, a long-term fix to stabilize clinical laboratory services reimbursements, and greater immigration flexibilities for physicians so they can continue to practice in the United States – especially in health care shortage and rural areas.

A new study published by Health Affairs Scholar uncovers an undercount in the workforce of pathologists as a result of omitting subspecialized training over several years. In this paper, “Re-evaluation of the Methodology for Estimating the U.S. Specialty Physician Workforce,” the authors from the CAP and the Association of American Medical Colleges (AAMC) suggest revisiting methodologies and definitions responsible for tracking the physician workforce as similar undercounts may exist in other physician specialties.

UnitedHealthcare is delaying the implementation of new requirements to use Z-codes for reimbursement. After an initial delay, UnitedHealthcare announced the start date as April 1, 2024. The new date of implementation, announced this week, is June 1, 2024. The CAP and affected laboratories had expressed concerns over the ability to submit claims under this new system. As a result, UnitedHealthcare is both working with many laboratories individually and providing additional time. UnitedHealthcare says it will continue to work with impacted laboratories.

On March 21, CAP President Donald Karcher, MD, FCAP, provided testimony to the House Energy and Commerce Subcommittee on Health during a hearing entitled “Evaluating Approaches to Diagnostic Test Regulation and the Impact of FDA’s Proposed Rule.” Dr. Karcher firmly stated the CAP’s opposition to the Food and Drug Administration (FDA) proposed regulation on the oversight of laboratory-developed tests (LDTs) and advocated for policy solutions that target full regulation of only the highest risk LDTs.

CAP President Donald Karcher, MD, FCAP, will provide testimony to the House Energy and Commerce Subcommittee on Health during a hearing entitled “Evaluating Approaches to Diagnostic Test Regulation and the Impact of FDA’s Proposed Rule” on March 21.

On March 8, Congress passed the 2024 Consolidated Appropriations Act that included additional relief from Medicare payment cuts. Physicians will receive a boost in Medicare pay for patient services starting from the legislation’s enactment through the end of 2024.

Following months of direct lobbying by the CAP and physician community, congressional leaders in a federal spending bill released on March proposed additional relief from Medicare payment cuts that went into effect January 1. Throughout 2023 and early 2024, the CAP strenuously lobbied lawmakers to enact short-term Medicare payment relief and now it appears Congress will increase physician pay from current levels by 1.68% if the spending bill becomes law.

Over 300 pathologists responded to an Action Alert by the CAP sent to its grassroots advocacy network encouraging outreach to their legislators to sign a Dear Colleague Letter drafted by Sens. John Boozman (R-AR) and Peter Welch (D-VT). The letter, sent to Senate leadership on February 22, emphasized the urgent need to address the 3.37% cut to Medicare physician payments that went into effect January 1. Thirty-two senators signed the letter.

The CAP is pleased to announce that Jake Sherman will keynote on the first day of the Pathologists Leadership Summit during the House of Delegates meeting. Mr. Sherman will offer a candid analysis filled with colorful anecdotes about what is driving politics and policy inside the nation’s capital during the Pathologists Leadership Summit, which is scheduled April 13 – 16, in-person only in Washington, DC.

The Center for Medicare and Medicaid Services (CMS) alerted the CAP that its Pathologists Quality Registry earned historical benchmarks for two more of their registry-specific Qualified Clinical Data Registry (QCDR) measures. This brings the total benchmarked QCDR measures to four. Benchmarking is critical for pathologists looking to maximize their scores while minimizing burden.

In September 2022, the House passed the Improving Seniors’ Timely Access to Care Act, a prior authorization bill to better serve patients and reduce unnecessary administrative burdens for clinicians. Since then, the Senate and House have been working with the Centers for Medicare and Medicaid Services (CMS) to advance the legislation to the President’s desk, but the bill’s cost has been a factor.

In September 2022, the House passed the Improving Seniors’ Timely Access to Care Act, a prior authorization bill to better serve patients and reduce unnecessary administrative burdens for clinicians. Since then, the Senate and House have been working with the Centers for Medicare and Medicaid Services (CMS) to advance the legislation to the President’s desk, but the bill’s cost has been a factor.

Congress avoided a partial government shutdown by passing a stopgap spending bill to fund federal agencies until March. Unfortunately, the spending bill did not include a provision to reverse a 3.37% Medicare cut to physician services in 2024. The CAP continues to express deep disappointment over Congress’s failure to stop the cuts and pursue a retroactive solution to reverse them.

The CAP, American Medical Association (AMA), and hundreds of medical organization and societies are lobbying Congress to quickly pass legislation to reverse the 3.37% Medicare physician payment cuts that took effect on January 1. The groups sent a letter[T(1] to both the House and Senate on January 16, calling on Congress to eliminate the cuts in full by increasing the Medicare Physician Fee Schedule Conversion Factor retroactive to January 1, 2024, by the initial January 19 appropriations deadline.

Due to a lack of congressional action in 2023, Medicare payment cuts impacting pathologists and other physicians went into effect on January 1. While Congress did anticipate and provide partial relief for these cuts in December 2022, they did not fully stop the cut.

Despite strong opposition from the CAP, the Centers for Medicare & Medicaid Services (CMS) finalized a regulatory proposal to allow individuals with a Doctor of Clinical Laboratory Science (DCLS) degree to qualify for high-complexity laboratory director positions.

Special Issue: The CAP expressed its deep disappointment after Congress will end its legislative session for 2023 without addressing future Medicare payment cuts to physician services. Overall, these services will receive a cut on January 1, 2024 after several years of similar cuts and insufficient updates to Medicare’s physician fee schedule to account for rising inflation.

Year after year, pathologists’ payments are being threatened to decline, workforce shortages are causing burnout, and cuts to clinical laboratory payments hang in the balance. Advocate for pathology and plan to attend the Pathologists Leadership Summit in-person where you will gain unparalleled access to the education and training to make an impact on Capitol Hill and protect the future of our specialty.