Advocacy Update

• Cytotechnologist Name Change Moves Forward Despite CAP Opposition and Risks
• New Rule Proposed for No Surprises Act IDR Fees
• CAP Presents Health Equity Update at CDC Lab Partners Meeting
• AMA Provides Tools and Resources for Physicians Looking for Learning Opportunities
• Take Our News Quiz for September

The Commission on Accreditation of Allied Health Education Programs (CAAHEP) Board of Directors voted at its September 15 meeting to approve the revised Standards and Guidelines for the Accreditation of Educational Programs in Cytology. Within the new standards and guidelines, they approved a name change and softened educational requirements compared to what had been previously proposed. Of specific concern, the name change moves forward despite the objections and strong opposition from the CAP.

According to these CAAHEP guidelines, a cytotechnologist is now referred to as cytologist, and cytotechnology is now referred to as cytology. In addition, there were changes to the education requirements. Cytotechnologists will be required to acquire a master’s degree. The cytotechnology program must now be sponsored by an education institution that offers master’s degrees at minimum, and the director of an educational program must possess a master’s degree in a relevant discipline. The CAP supported this change to the program which provides several years for programs to transition to a master's degree.

It is well documented that name changes are often the first step in scope of practice expansions. The AMA and the CAP have both prioritized fighting scope of practice expansion of non-physician providers, which can confuse and ultimately endanger patients. Since August 2020, the CAP has communicated its opposition to the name change citing a lack of baseline data that independently validated the necessity for the change. Furthermore, the impacts of the name change on the medical community have not been evaluated.

In a joint statement, the American Society of Cytopathology (ASC), American Society for Clinical Pathology (ASCP), and American Society for Cytotechnology (ASCT) had fully endorsed the name change and cited efforts to expand the scope of practice expansion for the profession.

The new standards will be posted on the commission’s website with an effective date of January 1, 2025. Per commission policy, the standards must be reviewed at least once every 10 years. The next review is due by September 2033.

On September 20, the Department of Health and Human Services (HHS), jointly with the departments of Labor and the Treasury proposed a new fee structure for the federal independent dispute resolution (IDR) process. This proposed rule would amend existing regulations for the IDR fees charged for single and batched determinations.

To engage in the federal IDR process, each party must pay to the certified IDR entity (1) the administrative fee due to the departments and (2) the entire certified IDR entity fee. The proposal makes changes to the administrative fee amount, the methodology used to calculate the administrative fee amount, considerations used to develop the certified IDR entity fee ranges, and the certified IDR entity fee ranges for disputes initiated on or after January 1, 2024. Specifically, the departments are proposing to increase the administrative fee to $150 per party, per dispute. This amount is not refunded to either party regardless of the outcome of the IDR determination. The IDR entity fee is also going up, but this amount is returned to the prevailing party.

The CAP has urged HHS not to increase the administrative fee from the original $50 amount, stating that an increase represents a significant barrier for small and rural providers/practices, and for most of pathology, in accessing the IDR process at all. The CAP will comment on the proposed rule and will continue to work with the CMS to address problems members and others are experiencing.

Previously, the Texas Medical Association recently sued Centers for Medicare & Medicaid Services (CMS) over several aspects of the No Surprises Act. In August, the CMS suspended the IDR process after a federal court judge ruled in favor of the Texas Medical Association. The judge found that the CMS did not follow processes to increase fees and ruled that the Departments cannot impose a substantial fee change without notice and comment rulemaking. The September 20 proposed rule is a direct response to that ruling.

On September 25, at the Clinical Laboratory Partners Forum convened by the Centers for Disease Control and Prevention (CDC), the CAP presented an update on the pathologists’ role in advancing health equity through diagnostic medicine. The update highlighted how the CAP has developed and adopted multiple policies stemming from the work of the Health Equity and Disparities Workgroup including Medicaid expansion, recognizing, and addressing the role of social determinants of health (SDOH) as an essential part of combating health care disparities and inequities among patients and addressing barriers to entry for underrepresented diverse populations in clinical trials.

The CAP’s legislative wins were also cited. The Consolidated Appropriations Act of 2023 signed into law at the end of 2022 included several of the CAP’s health equity and disparities priorities like diversity in clinical trials and physician workforce shortages that impede access to care.

Lastly, the CAP presented the health equity page on the CAP website and how the CAP convened a health equity webinar with CAP President Emily Volk, MD, FCAP, Board of Governor Kalisha Hill, MD, MBA, FCAP and Kisha Mitchell Richards, MD, FCAP, to discuss the importance of health equity initiatives in pathology and highlighted the CAP policy efforts in the health equity space.

The American Medical Association (AMA) is providing the resources for physicians seeking information about preventing physician suicide, information about an upcoming AMA in-person conference focused on innovation, and helpful podcasts on telemedicine and hypertension. See below for more.

Preventing and Addressing Physician Suicide

National Physician Suicide Awareness Day was September 17. Take steps to identify and support at-risk physicians with these AMA STEPS Forward® resources:

• Preventing Physician Suicide Toolkit
• After a Physician Suicide Toolkit
• Wellness-Centered Leadership Playbook

IN-PERSON EVENT

AMA Physician Innovation Network (PIN) at HLTH 23

October 10 | Las Vegas

Planning to attend HLTH 23? Join the AMA for a free PIN IRL (in real life) event! Space is limited, so RSVP today to secure your spot. If you cannot attend in person, tell us your success story of implementing solutions in your practice on the PIN platform.

AMA STEPS Forward® Podcast

The AMA, in collaboration with Manatt Health, released virtual care case studies in 2021 as part of the Return on Health Framework. Two years later, the AMA checks in on the progress.

• Return on Health part 1: Teleneurology and Telestroke Services
• Return on Health part 2: Telepsychiatry Program
• Return on Health part 3: Hypertension Digital Medicine Program

Are you up to speed on CAP advocacy news? Take our new monthly news quiz and see how many you can get right and share your results on social media.

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