Previous Advocacy Updates

As the COVID-19 public health emergency ended May 11, the Centers for Medicare & Medicaid Services (CMS) updated its guidance to allow pathologists the ability to review digital slides and data remotely as long as they meet specific criteria.

On the heels of a successful 2023 Hill Day that saw nearly 100 CAP members meet with 145 congressional offices, pathologists have amassed tangible legislative momentum — but we need to build on that by continuing to contact legislators. 

Enforcement discretion to allow pathologists to review slides remotely without the need of a separate CLIA certificate for their remote locations will continue once the public health emergency for COVID-19 ends later in May. However, reporting of COVID-19 laboratory results to the federal government will no longer have the authority to require this data to be reported from laboratories.

For our 2023 Hill Day, CAP members met with their federal lawmakers and advocated to protect the value of pathology services.

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 17. CAP Advocacy leaders prepared pathologists to lobby Congress on three main policies affecting the specialty: stopping Medicare cuts to pathology services, including laboratory service reimbursements, and resolving workforce shortage issues.

The CAP submitted comments in support of a recent proposal by the Food and Drug Administration (FDA) to relax rules on who is eligible to donate blood. Under draft recommendations announced January 26, monogamous gay and bisexual men would be allowed to donate blood and eligibility would be determined using individual risk-based questions.

On March 29, Reps. Terri Sewell (D-AL) and Brian Fitzpatrick (R-PA) introduced the bipartisan Resident Physician Shortage Reduction Act of 2023. This legislation would combat the nation’s physician shortage and improve access to health care by expanding the number of Medicare-supported medical residency positions by 14,000 over seven years. The CAP has long advocated for increased funding to support more GME residency slots, which is essential to addressing critical shortages of pathologists in the coming years and is one of the 2023 Advocacy asks.

The Centers for Medicare and Medicaid Services issued revised guidance for the federal independent dispute resolution (IDR) process that is part of the No Surprises Act. The new guidance is the direct result of the federal litigation filed by the Texas Medical Association that was decided in favor of physicians.

The CAP, the American Medical Association (AMA), and over 130 medical professional societies asked Congress to pass legislation that provides an annual inflation-based payment update based on the full Medicare Economic Index (MEI).

CAP President Emily E. Volk, MD, FCAP met with the Congressional Black Caucus (CBC) Health Braintrust during a forum to discuss strategies to address inequities that pathologists can take in health care.

The Washington State Pathology Society, in collaboration with the CAP, and the Washington State Medical Association, delayed a switch from the states’ balance billing dispute resolution process to the federal independent dispute resolution system for at least six months.

The Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) voted to recommend updating its Medicare coverage with evidence development (CED) criteria to improve the timeliness of trials and the diversity of data collected. However, the CAP and others, including MEDCAC advisers, remain concerned that CED restrictions will limit patient access.

The American Medical Association (AMA), the CAP, and over 110 other medical societies supported meaningful prior authorization reforms proposed for Medicare Advantage and the Medicare prescription drug benefit.

Once again, a federal judge in Texas agreed with physicians that the government’s regulations for the No Surprises Act are inconsistent with the statute.

The Cancer Leadership Council, of which the CAP is a member, asked the Centers for Medicare & Medicaid Services (CMS) to ensure that health plan essential benefits include molecular diagnostic tests and chimeric antigen receptor (CAR) T-cell therapies.

The Centers for Medicare & Medicaid Services (CMS) announced the first award of 200 Medicare-supported graduate medical education (GME) slots. These 200 are part of the 1,000 GME slots that Congress created as part of the Consolidation Appropriations Act of 2021.

As the 118th Congress took office in January, Republicans hold a slight majority in the House, making for a new speaker and committee leadership. House Speaker Kevin McCarthy (R-CA) was sworn in on January 7 along with the rest of Congress.

With a new year, there are several new laws and regulations now impacting pathologists and their practices.

In its 2023 federal funding legislation, Congress mitigated next year’s scheduled Medicare cuts to physicians, delayed implementation of pending cuts to clinical laboratory fees, and included a bill championed by the CAP to ensure the nation is prepared for future pandemics. The legislation did not include some other measures which the CAP asked Congress to adopt.

As Congress debates its year-end legislation for 2022, the CAP has laid out its priorities for inclusion in the year-end omnibus appropriations package.