Advocacy Update

• CAP President to Testify During Congressional Hearing on Laboratory-Developed Tests
• CAP Welcomes New CEO Michael Fraser
• CAP Urges CMS to Remove Local Coverage Determination Policies that Limit Scope of Practice
• CMS Extends 2023 MIPS Data Submission Deadline Until April 15 Due to Impact of Change Healthcare Cybersecurity Attack
• CSP and CAP Support Amending Medicaid Bill to Ensure Access for Pathology Patients
• Take Our News Quiz for March

CAP President Donald Karcher, MD, FCAP, will provide testimony to the House Energy and Commerce Subcommittee on Health during a hearing entitled “Evaluating Approaches to Diagnostic Test Regulation and the Impact of FDA’s Proposed Rule” on March 21.

The CAP greatly appreciates the leadership of the Energy and Commerce Committee and its members for prioritizing this issue and holding a congressional hearing to further explore the oversight of laboratory-developed tests. Through the years, the CAP has advocated for an oversight approach that ensures patient safety and access to quality testing, mitigates regulatory burden on laboratories, and allows for the continued innovation of new tests. For more information on the CAP’s position on this issue, read Dr. Karcher’s recent column in CAP TODAY and the CAP’s December 4, 2023 letter to the Food and Drug Administration regarding the agency’s proposed LDT oversight regulation.

For more information about the hearing, please read the Energy and Commerce Committee press release.

The CAP welcomed Michael Fraser, PhD, MS, CAE, FCPP as its new Chief Executive Officer (CEO). Fraser brings over 25 years of medical association management experience and a track record of solid leadership in the health care sector.

Previously serving as CEO at the Association of State and Territorial Health Officials (ASTHO), Fraser played a pivotal role in shaping public health policy across 59 states and territories.

"I bring a ‘startup energy’ that lets me see things from a fresh perspective—the opportunities as well as the challenges,” said Fraser. “That’s what fuels my passion, and I can’t wait to learn more about the specialty and contribute to the CAP’s ongoing success.”

Fraser is enthusiastic about building strong relationships across the CAP. Read more.

The CAP and the Association for Molecular Pathology (AMP) have expressed great concern about a local coverage determination (LCD) that improperly interferes with anatomic pathologist’s scope of practice and attempts to define the practice of medicine. The LCD imposes restrictions, as a condition of coverage, as to the subspecialty qualifications of those who can order certain tests.

On March 1, CAP and AMP sent a joint letter to the Centers for Medicare and Medicaid Services (CMS) requesting that the subspecialty requirement in the MolDX: Molecular Assays for the Diagnosis of Cutaneous Melanoma LCD be removed immediately. The requirement states that any molecular test approved for coverage under the LCD must be ordered by a board-certified or board-eligible dermatopathologist. The groups further urged the CMS to work with its Medicare Administrative Contractors to ensure that local coverage policies in the future do not improperly limit the scope or define the practice of medicine by board-certified pathologists.

Read more about the Medicare Local Coverage Program.

The Centers for Medicare and Medicaid Services (CMS) has extended the 2023 Merit-based Incentive Payment System (MIPS) data submission deadline until April 15. The deadline was originally scheduled to close on April 1, but due to ongoing concerns with the impact the Change Healthcare cybersecurity attack is having on physician practices, the CMS has extended the 2023 MIPS data submission deadline. Data can now be submitted and updated until 8 PM ET on April 15, 2024.

In addition, on March 13, CMS published FAQs related to the Change Healthcare/Optum payment disruption accelerated and advance payments. These go into detail about what services qualify for accelerated and advance payments, application criteria, terms of repayment, financial concerns, and other topics.

If you would like your practice to reap the benefits of a team of experts offering practice-specific support for complying with MIPS—and receive proper compensation for the value you provide—please contact our representatives today at 800-323-4040, option 3 or email us at registry.inquiries@cap.org to learn about the Pathologists Quality Registry.

The Connecticut Society of Pathologists (CSP), with CAP support, urged the amending of Raised Bill 5459, to expressly include pathology and laboratory medicine under the category of "select providers." The current legislation omitted pathology and laboratory services from the definition of "select providers" that would benefit from a new rate methodology that would adjust Medicaid rates "to a specified percentage of Medicare for the same service." The CSP noted that pathology and laboratory services were included in a state issued report, released in February that found significant disparities in payment for pathology and laboratory services in the state Medicaid program when compared with a sample of five other states and Medicare.

In submitted March 12 testimony, the CSP stated: “The language of the definition in the legislation appears exclusionary as it does not state "including, but not limited to," which would allow pathology and laboratory medicine to be implicitly included as specialist services...”

Both the CSP and the CAP believe that Medicaid payment rates should be raised to Medicare rates as part of ensuring access to heath care for Medicaid patients. Without payment levels commensurate with Medicare, Connecticut risks deterioration in quality and turn-around time, and loss of patient access to convenient on-site and specialized pathologist and laboratory services.

The CSP noted “given the integral and omnipresent role of pathology and laboratory medicine in health care, especially cancer care, and the inclusion of such services in the Phase 1 Report, all these factors compellingly justify the amendment of Raised Bill 5459 to expressly include "pathology and laboratory services.”

Learn more about how the CAP supports state pathology societies and partners with them to influence public policy.

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