Advocacy Update

• CAP Secures Medicare Pay Boost to Pathologists in New Spending Plan Proposal
• CAP Urges CMS to Revise Flawed LCD Process
• CAP and over 50 Physician Groups Urge Lawmakers to Mitigate Health Care Workforce Shortage
• Get Insights on the Dynamics of the 2024 Elections During Pathologists Leadership Summit Monday Keynote Address
• 2023 Health Equity Advocacy Accomplishments
• CAP Wins 2024 Trendy Award for Stop Medicare Cuts Advocacy Campaign
• Take Our News Quiz for March

Following months of direct lobbying by the CAP and physician community, congressional leaders in a federal spending bill released on March proposed additional relief from Medicare payment cuts that went into effect January 1. Throughout 2023 and early 2024, the CAP strenuously lobbied lawmakers to enact short-term Medicare payment relief and now it appears Congress will increase physician pay from current levels by 1.68% if the spending bill becomes law.

Medicare’s payment formula had cut pathology services by 2.72% in 2024 while some other physician specialties faced higher reductions. The new spending package proposed on March 3 would increase Medicare pay for the remainder of the year by 1.68%, meaning that overall pathology pay would be 1.04% lower in 2024 compared to last year.

Specific actions the CAP took to achieve this increase to pathology pay include:

• Activating our PathNET grassroots network supporting House leaders in addressing the Medicare cut.
• Activating PathNET to support Senate leaders in addressing the cut.
• Executing a virtual “fly-in” where 60 pathologists met with top lawmakers and advocate for relief from Medicare cuts.
• Holding several high-level meetings to discuss Medicare cuts with the offices of congressional leaders, such as Senate Majority Leader Chuck Schumer and Senate Minority Leader Mitch McConnell.
• Meeting with 145 congressional offices to discuss the Medicare cuts and the impact they have on pathology practices across the country during our 2023 Hill Day.

The spending plan is expected to pass the House and the Senate by March 8. While the CAP has urged Congress to enact a short-term fix to Medicare cuts, the CAP will be advocating for long-term reform during the Pathologists Leadership Summit.

The CAP has repeatedly appealed to the Centers for Medicare and Medicaid Services (CMS) to remedy significant issues with the local coverage determination (LCD) decision-making process. An LCD is a decision made by a Medicare Administrative Contractor (MAC) on whether a particular service or item is reasonable and necessary, and therefore covered by Medicare within the specific jurisdiction that the MAC oversees. MACs are Medicare contractors that develop LCDs and process Medicare claims. The CAP believes that the elements critical to ensuring sound local coverage policy have been compromised as a result of CMS’ October 2018 revisions to the LCD guidelines. In a February 23 letter to the CMS, the CAP recommended the following:

• MACs take a more aggregate view of LCD development including published evidence as well as clinical expertise that physician CAC representatives have to offer.
• The CMS requires MAC open meetings to provide a more open forum for information exchange between MACs and stakeholders on new or revised LCDs and establish a minimum period of three weeks between posting an open meeting notice and date of the meeting.
• MACs be required to issue a final LCD on valid reconsideration requests within 180 days from the date the public comment period ends and MACs post a tracking sheet to their website with timely disclosure of information appropriate to reconsideration requests.
• The CMS require new Local Coverage Articles (LCA) or coding updates to existing LCAs that reflect non-routine changes in coding and that impact coverage, are subject to public notice and comment before new or revised LCAs take effect.
• The CMS adds key LCD process measures to the current MAC performance metrics to assess performance effectiveness and adherence to specific LCD guidelines and as outlined in MAC contracts.

The CAP will continue to engage with the CMS on important issues related to Medicare LCD reform. Visit the CMS’ Local Coverage Determination Process & Timeline for more information.

The CAP and more than 50 physician and health care groups strongly urged Congress to support the Healthcare Workforce Resilience Act.

In a February 27 letter to the House and Senate, the groups said the United States is facing an urgent health care workforce shortage that is expected to get worse over the next decade. In response to this crisis, the groups strongly support the Healthcare Workforce Resilience Act. This legislation would initiate a one-time recapture of up to 40,000 unused employment-based visas – 25,000 for foreign-born nurses and 15,000 for foreign-born physicians – so they can strengthen and provide stability to the US health care system. The legislation would also allow for thousands of international physicians who are currently working in this country on temporary visas with approved immigrant petitions to adjust their status.

The CAP will continue its advocacy efforts finding legislative solutions to address the health care workforce shortage and protect the value of pathologists.

The CAP is pleased to announce that Nathan Gonzalez and David Wasserman will keynote on Monday, April 15 of the Pathologists Leadership Summit. Join two editors at the nation's most esteemed nonpartisan publications, for a thought-provoking session that delves into the dynamics of electoral politics. Dive deep into their analysis, fueled by poll numbers, data, historical insights, trends, and demographics, to gain insights on the road ahead in the 2024 election.

Don’t miss “Understanding the Dynamics of the 2024 Elections” keynote address on April 15 from 12:30-1:30pm, Register now!

Since the COVID-19 pandemic the CAP has developed numerous health equity public policies including Medicaid expansion to promote access to health care, bolstering Medicaid funding for US territories, addressing social determinants of health (SDOH), increasing diversity in clinical trials, and strengthening independence in medicolegal death investigations for physicians. The CAP’s work on health equity and disparities in 2023 include:

Federal

• CAP past-President Emily Volk, MD, FCAP was invited by Rep. Robin Kelly (D-IL), Co-Chair of the Congressional Black Caucus Health Braintrust, to participate in a diverse provider roundtable to discuss their health equity priorities.

Regulatory

• The CAP presented at the Clinical Laboratory Partners Forum led by the Centers of Disease Control and Prevention (CDC) on the pathologists’ role in advancing health equity through diagnostic medicine.

Policy

• The CAP endorsed the National Association of Medical Examiners (NAME) new position noting that ‘excited delirium’ is not a medical diagnosis and should not be used as a cause of death.

Communications

• The CAP received an award from the American Association of Medical Society Executives (AAMSE) for its “Multi-Channel Communications Campaign to Drive Awareness of the CAP’s 2022 Priority to Advocate to Reduce Health Disparities.”
• Peer article by Dr. Volk on her meeting with the Congressional Black Caucus.
• A podcast segment on Sickle Cell Disease: that highlights the importance of sickle cell disease awareness and adequate care for all those impacted with the condition.
• A statement supporting the discontinuation of the term excited delirium as a cause of death and a podcast explaining this position.
• Peer article on gender neutral blood screening as the CAP supported new screening criteria for blood donors.

The CAP is continuing to advocate and identify additional policy areas to prevent health disparities and improve health outcomes for all. Visit our Advocating for Health Equity page for more information.

On February 27 in Washington D.C., the CAP’s advocacy communications campaign to stop Medicare cuts was awarded a bronze-level TRENDY Award for Best Advocacy Campaign. The awards honor the best marketing and communication pieces in the association and nonprofit community. The advocacy campaign supported CAP-member and staff lobbying to stop cuts to pathologists Medicare payment in 2023 and featured an advertising and media strategy to raise awareness of the pathologists’ role in patient care and further support access to pathology services.

The campaign featured a mix of digital and out-of-home advertising, in addition to earned media tactics (eg, opinion articles and letters to the editor), targeting health care policy influencers in Washington, DC. The digital advertising—utilizing Google Display, The Washington Post, LinkedIn, and other ad delivery channels—then supported lobbying throughout the rest of the year to stop Medicare cuts to pathology and other physician services. The advertisements featured 30-second and 15-second versions of a video on The Washington Post’s website in October calling on Congress to protect access to pathology services by addressing the Medicare cuts.

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