Advocacy Update

• AMA, CAP Urge VA to Reconsider Scope of Practice Changes for Nonphysicians
• CDC Revises COVID-19 Recommendations for Vaccinated Individuals
• California Pathologists Secure Favorable Reimbursement Law
• Webinar This Week – Proposed 2022 Medicare Payment Regulations Impact on Pathology Services
• Breaking Advocacy News? Check out the Advocacy Twitter Channel
• 75th Anniversary Featured in July Advocacy News Quiz

The CAP and the American Medical Association (AMA), along with over 100 other health care and medical professional groups, opposed the recent action taken by the Department of Veterans Affairs (VA) that proposes that nonphysicians can provide health care services that are outside their scope of practice. The VA is proposing to invoke the Supremacy Clause of the US Constitution to preempt state and local scope-of-practice laws as it develops national standards of practice, enabling nonphysicians to provide health services and procedures outside their scope of medical practice. The CAP strongly advocates to protect patients and the pathologists’ scope of practice.

In a July 26 letter, the CAP, AMA, and several other medical groups opposed the recent Federal Supremacy Project that would develop national standards of practice for 48 health care occupations at VA. This could enable nurses, physician assistants, and other nonphysicians to provide services and perform procedures outside the scope of their knowledge and licensure. The groups also questioned the feasibility of developing a single national standard of practice for all VA-employed physicians.  

In the letter, the groups stated that they “believe the VA has failed to consider that these health professionals do not operate in isolation but rather as a team. Yet, the VA is creating and moving standards forward independent of one another. To provide the best care for our Veterans, the VA must engage in a systematic examination of how all these standards will fit together and affect the health professional team.” The groups further urged the VA to reconsider its plans.

On July 27, the Centers for Disease Control and Prevention (CDC) updated its guidance for fully vaccinated Americans as coronavirus cases have risen in recent weeks due to the COVID-19 Delta variant circulating in the United States.

In addition to getting a COVID-19 test when experiencing symptoms, the CDC recommended fully vaccinated Americans get tested 3-5 days following a known exposure to someone with suspected or confirmed COVID-19. While awaiting the results of a test, Americans should wear masks in public indoor settings for 14 days after exposure or until receipt of a negative test result.

The CDC also recommended that fully vaccinated people wear a mask in public indoor settings where there is evidence of substantial or high transmission rates. The CDC tracks these areas of the United States online.

Additional guidance also included information that fully vaccinated people can choose to wear a mask regardless of level of transmission, particularly if they, or someone in their household, are immunocompromised or at risk for severe disease from COVID-19. The CDC also recommended universal indoor masking for all teachers, staff, students, and visitors to schools regardless of vaccination status.

On July 27, California Gov. Gavin Newsom signed a comprehensive health care budget trailer bill (AB 133), which raised the Medi-Cal rate methodology to 100% of Medicare for clinical or laboratory services and prevents future retroactive reimbursement reductions and recoupments. Additionally, the law notably expands Medi-Cal coverage to low-income undocumented adults aged 50 and older. The California Society of Pathologists (CSP) successfully advocated for increasing the Medi-Cal payment rates to 100% of Medicare as reflected in the new law. The CAP works closely with state pathology services to advocate for equitable reimbursement for pathology services.

“Though the new rates won’t take effect until 2022, this was the culmination of a legislative effort over a number of years supported by the CSP” stated Executive Director of CSP, Robert J Achermann, JD.

Previously, the 2021-2022 State Budget included relief on Medi-Cal laboratory rates including certain anatomic pathology codes. The Medi-Cal utilized a rate methodology of no more than 80% of Medicare or the lowest of enumerated criteria. Numerous retroactive recoupments to labs and pathology groups have been made since due to “a lack of timeliness in Medi-Cal updating their rates.” Beginning on July 1, 2022, the raised Medi-Cal rates will be implemented.

On July 13, the Centers for Medicare & Medicaid Services (CMS) released the proposed 2022 Medicare Physician Fee Schedule and the Quality Payment Program regulations, including the Merit-based Incentive Payment System (MIPS). On Thursday, August 5 at 1 PM ET/12 PM CT, the CAP will offer this complimentary live webinar where CAP experts will review the proposed regulation that will impact payment for services and pathologists’ participation in the Quality Payment Program.

Webinar presenters will be the Council on Government and Professional Affairs Chair Jonathan Myles, MD, FCAP; Economic Affairs Committee Chair Stephen Black-Schaffer MD, FCAP; Economic Affairs Committee Vice-Chair Ronald McLawhon, MD, FCAP, and Quality and Clinical Data Registry Affairs Committee Chair Diana Cardona, MD, FCAP.

Register today

Want up to the minute CAP Advocacy news? Then follow us on twitter at CAPDCAdvocacy, where you will be the first to know about CAP Advocacy wins, see your fellow members engage with congressional leaders on key policies affecting the practice of pathology and, of course, breaking Advocacy news.

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This month we are featuring the CAP’s 75th anniversary, with a special prize for the first 50 CAP members to take the quiz. Last month, over 70 pathologists took the quiz. See how you compare against your fellow CAP members’ in the July News Quiz and brag about your top scores on social!

Take the news quiz