Advocacy Update

• Congress Takes Steps Toward Passing $1.9 Trillion COVID-19 Relief Bill
• House Committee Reviews Latest COVID-19 Testing, Needs for Additional Support
• CAP Urges Missouri House to Revise Autopsy Bill
• Take the February Advocacy News Quiz
• Last Chance to Share How You’ve Been Affected by COVID-19

The House and Senate agreed to a budget plan on February 5 that is needed to enact a proposed $1.9 trillion COVID-19 response and relief package. The CAP is tracking the legislation and engaging with Congress on pathologists’ priorities for combating the COVID-19 pandemic.

In January, President Biden announced the policy framework for his American Rescue Plan. Democrats are moving to enact the bill through a budget reconciliation process. The House and Senate have taken the first steps to use the budget reconciliation by agreeing to the budget plan and instructing key committees to draft legislative text. In recent past, Congress has used this process to repeal parts of the Affordable Care Act and pass tax reform legislation.

Key provisions concerning health care in the plan include:

• $50 billion to expand testing across the United States. This includes assisting schools, prisons, and health care facilities with testing programs and expanding laboratory capacity. $46.5 billion would be allocated to procure and administer regular screening tests and $3.5 billion would go toward investments in laboratory capacity for tests.
• $35 billion, with 20% set aside for rural hospitals, to replenish the Provider Relief Fund.
• $30 billion for the Disaster Relief Fund used for boosting personal protective equipment, laboratory supplies, and reimbursement to state and local governments for emergency response.
• $20 billion for a federal government vaccination campaign.
• Additional investment in virus surveillance, sequencing, and analytics.

The CAP will provide additional updates on this pandemic relief plan in future editions of Advocacy Update.

On February 3, the House Energy and Commerce Subcommittee on Health gathered testimony on the administration’s COVID-19 relief and response plan. Two Biden COVID-19 advisors who spoke at the hearing advocated for significant investments in vaccine distribution, testing, data collection, education, and coordination between the federal government and the states. The CAP has called for similar support from the administration.

House lawmakers and hearing panelists further discussed issues with COVID-19 testing supply shortages. The CAP has collected data showing testing supply shortages during the COVID-19 pandemic and has advocated for solutions to address supply chain issues.

The Health Subcommittee hearing included Luciana Borio, MD, and Julie Morita, MD, from the White House COVID-19 response team. The hearing came as Congress works toward passing a large COVID-19 relief and response package put forth by President Biden.

During the hearing, Drs. Borio and Morita discussed how public health experts called for a comprehensive, national testing strategy “that would ensure testing supplies were allocated efficiently, and tests were available to all who needed them.” At the end of 2020, Congress passed legislation requiring the Department of Health and Human Services (HHS) to develop a comprehensive national COVID-19 testing strategy. The strategy is required to be completed by late-March 2021. The Government Accountability Office has also called for a national strategy as recently as January. Such a strategy should include a clear purpose, risk assessment, goals, and a coordination plan.

The CAP urged Missouri State House to clarify technical concerns with a current autopsy state house bill where only pathologists are the ones who conduct or oversee autopsies and how to communicate with the deceased family after the autopsy. Through its state advocacy program, the CAP lobbies state legislatures to ensure that pathologists have a scope of practice consistent with their education and training.

In a January 19 letter to Missouri House Rep. Ian Makey, Chair of the Federal and State Affairs Committee, David Gang, MD, FCAP, outlined the CAP’s issues with Missouri State House Bill 131. Dr. Gang serves as the chair of the CAP’s Federal and State Affairs Committee. The problems include clarification on the autopsy system and tissue definition about the deceased family consultation.

The CAP has technical and scientific concerns with Missouri State House Bill 131. It suggests amendments “to mitigate potentially burdensome obligations that will overwhelm the already highly strained medical examiner and autopsy system.” Currently, under Missouri law, pathologists are exclusively qualified to conduct autopsies. Any person who assists in autopsies, “under the direction of a pathologist, and who is not licensed as a physician under chapter 334 shall register with the division of professional registration of the department of commerce and insurance,” Dr. Gang stated in the letter.

Furthermore, the CAP sought for the bill to ensure that the medical examiner or pathologist is unimpeded in communicating with the next of kin or family of the decedent regarding the disposition of retained organs or tissues. The CAP also wanted to clarify when to communicate to the deceased family member only when it applies to an "intact organ or large tissue specimen.

“We don't believe that the sponsor's intent, nor the decedent's family interest is to create a mandate on pathologist notification regarding cellular remains of a non-significant nature, but instead should be focused on the disposition of ‘intact organs and large tissue specimens,’ which could hold emotional or religious significance to the decedent's family or next of kin.”

Test your advocacy knowledge with the February news quiz. See how you compare against your fellow CAP members’ in the February News Quiz.

Take the February news quiz

Today is the last chance to share how the COVID-19 pandemic has impacted your practice by completing the CAP survey. The survey will close at 5 PM ET on February 10. Data from this survey is critical for informing CAP leaders, policymakers, and government regulators of the current economic and personal challenges that pathologists are facing as a result of the pandemic.

Participation is vital as the CAP can then fully understand the gravity of COVID-19 on laboratories and testing. All board-certified pathologists, including CAP members, who have not taken the survey yet should have received an email this morning with your personalized invitation. If you can’t find your invitation, please write us at practicesurvey@cap.org, and we will send you a link to the survey. All participants who complete the survey will receive a $5 Amazon gift card. The CAP recognizes the value of your time and privacy, and your information will be treated as confidential and will not be associated with you or with your practice/group.