Previous Advocacy Updates

The FDA approved the CAP for admission to its Network of Experts to provide the agency with additional expertise on pathology and laboratory medicine issues, such as those concerning the COVID-19 pandemic and artificial intelligence.

The CAP successfully advocated to include new CPT codes for pathology clinical consultation services in the proposed 2022 Medicare Physician Fee Schedule but urged the CMS to clarify the codes before implementation.

Building on the 21st Century Cures Act, the CAP engaged with House lawmakers to advance medical research and foster a new era of medical innovation.

The CAP and the Cancer Leadership Council have called on physicians to get the COVID-19 vaccine and protect the patients they serve.

A $1 trillion, bipartisan infrastructure bill passed the Senate on August 10 after months of negotiations, but associations representing physicians and other medical groups have taken issue with plans to use cuts to Medicare to partially pay for the legislation. Congress is expected to address several Medicare issues through the budget reconciliation process after elected officials return from the August recess. The CAP will be actively lobbying the Congress throughout this process on a number of issues impacting pathology.

The CAP and the American Medical Association opposed the recent action taken by the Department of Veterans Affairs that nonphysicians can provide health care services.

On July 22, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) to import and increase the supply of “blue-top” test tubes.

On July 13, the CMS released the proposed 2022 Medicare physician fee schedule by including CAP-developed pathology Consult Codes.

Special Issue: The CAP successfully advocated for the inclusion of new and improved codes and values for pathology consultation services in the proposed 2022 Medicare Physician Fee Schedule.

On July 1, the departments of Health and Human Services, Treasury, and Labor issued regulations implementing portions of the No Surprises Act that bars surprise billing.

On June 24, bipartisan senators and representatives introduced the Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, which would provide regulatory oversight of laboratory-developed tests if enacted into law. The CAP had engaged with the VALID Act’s sponsors and other stakeholders to suggest improvements to the bill over the last year.

The CAP provided key recommendations for implementing the No Surprises Act to the Department of Health and Human Services as it will issue regulations and guidance before the law goes into effect January 1, 2022.

The CAP urged the Department of Health and Human Services (HHS) and other key federal agencies to take immediate actions to increase the supply of sodium citrate light blue-top tubes used for coagulation testing.

In response to the CAP’s engagement, Cigna informed the CAP on June 7 that the decision is imminent. The CAP learned health insurance payer Cigna plans to continue reimbursing pathologists for the professional component of clinical pathology services. A formal update regarding the policy to pay for the professional component of clinical pathology would be forthcoming soon.

CAP leaders met with top officials from the Food and Drug Administration to detail its concerns about the oversight of laboratory-developed tests on May 20.

A new Medicare proposal would repeal that hospitals report negotiated charges for all its Medicare Advantage, which the CAP had previously advocated against.

A record-breaking number of CAP members advocated to protect the value of pathology services on May 4 during the CAP’s Hill Day.

To prepare for the CAP’s annual Hill Day, CAP members discussed strategies for how they will engage their members of Congress and lobby to mitigate future Medicare cuts at the Pathologists Leadership Summit.

The CAP strongly urged the health insurer Cigna to rescind a new payment policy to deny claims when the professional component (modifier 26) of clinical pathology is billed.

Because of CAP advocacy and support from the American Medical Association, Congress finalized bipartisan legislation that extended the moratorium on a 2% cut to physician Medicare payments until the end of 2021.