Previous Advocacy Updates

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.

As Congress negotiates year-end legislation, the CAP is urging lawmakers to prevent scheduled Medicare cuts in 2023 and protect Medicare payment for clinical laboratory fees before December 31. The CAP is also actively advocating for policies that prepare the country for future pandemics and to protect provisions in legislation providing guardrails on the federal oversight of laboratory tests.

The CAP strongly opposed the health insurer Highmark’s new credentialing requirements for next-generation sequencing testing that imposes independent third-party validation of NGS results and/or variants of uncertain significance interpretation.

The CAP recently asked the Centers for Medicare & Medicaid Services to evaluate remote sign-out practices for pathologists after the public health emergency ends.

In an advocacy win for the pathologists, the Centers for Medicare & Medicaid Services finalized the proper rank order of the clinical labor rates for histotechnologists and laboratory technicians in the final 2023 Medicare Physician Fee Schedule (PFS).

Special Issue: On November 1, the Centers for Medicare & Medicaid Services released the 2023 Medicare payment regulations, including the final 2023 Medicare Fee Schedule and Quality Payment Program regulations.

In response to a congressional request for information regarding the potential reform of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the CAP provided feedback regarding pathologists’ experience in dealing with the current payment program and potential actions Congress could take to stabilize the Medicare payment system by reforming MACRA.

In response to an outbreak of Ebola in East Africa, the US Centers for Disease Control and Prevention (CDC) released guidance for clinical laboratories for Ebola specimen collection in the United States on October 18.

On September 28, CAP President-elect Donald Karcher, MD, FCAP, urged in public testimony to the Council of the DC to reconsider laboratory personnel licensure and additional statutory fixes in lieu of repeal within the personnel clean-up bill.

During the CAP 22 Annual Meeting, CAP members gathered in person and virtually and participate in an informative Advocacy Town Hall.

The Council of Medical Specialty Societies (CMSS), a coalition of 48 specialty societies, awarded the CAP $100,000 grant to study how to make pathology reports more patient-centered and understandable.