Previous Advocacy Updates

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.

On December 7, the House Energy & Commerce Committee passed legislation that mitigates the impact of the Medicare cuts in 2024, mirroring action taken by the Senate Finance Committee that would also raise the budget neutrality threshold and extend bonuses for alternative payment models.

Citing substantial undue regulatory burdens and costs on laboratories, the College of American Pathologists (CAP) called on the US Food and Drug Administration (FDA) to make significant changes to its proposed regulation of laboratory-developed tests (LDTs) in a letter to the FDA on December 4.

In August, the CAP met with the Centers for Medicare and Medicaid Services (CMS) to advocate for an increase in the cytotechnologist labor rate. In the 2024 Medicare Physician Fee Schedule, the CMS agreed with the CAP’s request and finalized a two-year, phased-in increase of 12% starting in 2024.

Special Issue: The CAP is encouraging its members to register their written comments to the US Food and Drug Administration (FDA) regarding the proposed rulemaking on laboratory-developed tests (LDTs) before the comment period ends on December 4.

On November 13, CAP leaders met with officials from the Food and Drug Administration (FDA) to ask clarifying questions about the FDA’s proposed regulation of laboratory-developed tests (LDTs) and how these rules would affect laboratories and patients. The CAP is in the process of drafting its comments and sought clarification on the proposal to inform its comments, due to the FDA by a December 4 submission deadline.

In its formal comments to the Centers for Medicare & Medicaid Services (CMS), the CAP urged the federal agency to stop Medicare cuts to pathologists next year, make the Merit-based Incentive Payment System (MIPS) less taxing on pathologists, and maintain remote sign-out capabilities for pathologists under CLIA.

Special Issue: The Centers for Medicare and Medicaid Services (CMS) released the 2024 final Physician Fee Schedule and Quality Payment Program regulation on November 2. The CMS reacted favorably to the CAP’s comments to increase pay to pathologists in 2024 from what had been first proposed in July.

On October 26, over 60 pathologists participated in a “virtual fly-in” and met with their federal policy makers to lobby Congress to mitigate a 2.75% Medicare cut to pathology services in 2024.

The CAP posted a statement and sent messages to members of Congress last week commending the House Energy and Commerce Committee for holding hearings on the Saving Access to Laboratory Services Act legislation to extend incentive payments for participation in eligible alternative payment models, Provider Reimbursement Stability Act of 2023, and the Improving Seniors Timely Access to Care Act of 2023.

On September 19, the House Ways and Means Committee held a Hearing on Reduced Care for Patients: Fallout From Flawed Implementation of Surprise Medical Billing Protections which shined a light on private insurers refusing to negotiate payment to physicians in good faith before arbitration, and not paying providers after there was a ruling in their favor.

The CAP and a coalition of 46 healthcare organizations representing over 1.2 million physician and non-physician providers and the patients they serve urged Congress to halt the implementation of the evaluation and management service add-on code G2211 created by the Centers for Medicare & Medicaid Services (CMS).