Advocacy Update

• CAP Pushes Congress to Pass Latest 2025 Medicare Pay Fix Plan
• Pathology Included in 2026 MIPS Value Pathways Candidates
• US Preventive Services Task Force Issues Draft Recommendations on Screening for Cervical Cancer
• Register for the CAP's Third LDT Webinar on January 9 - Ready Your Laboratory for the FDA's Stage 1: Corrective Action and Removal Reporting

With a government funding deadline looming on December 20, Congress released just this afternoon a 2025 spending plan that included relief from Medicare payment cuts to physician services. The CAP applauded the proposal and continues to press lawmakers to enact the relief ahead of an expected 2.5% cut to Medicare pay for pathology services effective on January 1, 2025.

The three-month 2025 spending plan includes a Medicare physician pay increase of 2.5% for one year. Absent congressional intervention, the 2.5% cut would affect all pathology and other physician services next year.

The CAP has lobbied Congress throughout 2024 to avert all Medicare decreases to pathology payment. Recently, the CAP set up an action alert for pathologists to urge their representatives and senators to support a pay fix in 2025. Pathologists can still easily send a message in support of this solution to their legislators.

Other policy wins in the spending plan championed by the CAP include a 3.53% bonus for participation in an Advanced Alternative Payment Model.

The CAP will continue to update members on the status of year-end congressional action.

On December 11, the Centers for Medicare and Medicaid Services (CMS) released its 2026 MIPS Value Pathways (MVPs) candidates for a 45-day comment period, closing on January 24. This release does not represent official proposal of the candidate MVPs for CY2026; the CMS is soliciting public feedback on these drafts in advance of potentially including them in the 2026 Medicare proposed rule. In the past, every candidate MVP released for public comment in the winter has been proposed as part of the following rulemaking cycle.

On the list is a Pathology MVP, which includes publicly-available Quality Payment Program (QPP) measures owned by the CAP, proprietary CAP quality clinical data registry (QCDR) measures, and proprietary QCDR measures from another registry - a billing company called MSN Healthcare. Based on feedback from the CAP earlier this year, the CMS modified the Improvement Activities included in the MVP.

However, the CMS declined to accept the CAP’s suggestion that additional CAP QCDR measures be added to the MVP. There are four CAP QCDR measures and four MSN QCDR measures.

The MVP candidates may be proposed in future rulemaking, but the decision to propose an MVP in rulemaking will be determined by the CMS. The CMS defines a candidate as "a draft MVP submitted to CMS for consideration in future rulemaking." Any future changes to finalized MVPs can occur through the Maintenance Process for MVPs. MVPs are voluntary. If this MVP is finalized, pathologists will have it as a reporting option in Medicare’s Quality Payment Program. By 2029, the CMS will sunset traditional MIPS in favor of MVPs, thus making MVP reporting mandatory.

The CAP will write and submit comments on the candidate Pathology MVP.

The US Preventive Services Task Force (USPSTF) recently posted a draft recommendation statement on screening for cervical cancer. The recommended changes include HPV primary screening every 5 years as the preferred screening strategy starting at the age of 30 years and self-collected HPV testing. The USPSTF believes these updates will increase testing among the generally under screened for the first time.

The Task Force concludes that adequate evidence demonstrates similarity in the accuracy of self-collected screening and clinician-collected HPV screening. USPSTF recommends that clinicians screen women ages 21 to 29 every 3 years with a Pap test. For women ages 30 to 65, the Task Force recommends screening with an HPV test every 5 years. Alternative effective screening options for women 30 to 65 include getting a Pap test every 3 years or getting a combined HPV and Pap test every 5 years, also known as co-testing. The USPSTF recommends this due to the high certainty that the net benefit is substantial.

The Task Force recommends against screening women younger than age 21, women older than age 65 who have had regular screenings with normal test results, and women of any age who have had regular screenings with normal test results, and women of any age who have had a total hysterectomy. The USPSTF said there is moderate or high certainty that the recommendation has no net benefit to the patient.

All three screening methods—HPV tests, Pap tests, and co-testing—are recommended by the Task Force.

The group's draft recommendation statement and draft evidence review have been posted for public comment on the Task Force website. Comments can be submitted through January 13, 2025 online.

The CAP is reviewing the draft recommendations. Read the full recommendations here.

Join the CAP on January 9 at 1:00 PM ET for the third webinar in our laboratory-developed tests series. Learn the necessary steps to comply with the FDA requirements for corrective action and removal reporting specific to laboratory-developed tests. This webinar and others in the series are intended to help laboratories prepare for the FDA final rule. Presenters are Bobbi Pritt, MD, FCAP, Deeona R. Gaskin, JD, MPH, and Earle S. Collum, MD, FCAP.

Register online