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Medicare Payment, Workforce, LCD Top CAP 2025 Policy Agenda

Policy Priorities Will Protect Patient Access to Accurate, Timely Lab Test Results

The College of American Pathologists (CAP) represents over 20,000 board-certified pathologists dedicated to advancing excellence in pathology and laboratory medicine. Our advocacy efforts focus on ensuring that pathologists can continue to provide accurate diagnoses and optimal patient care. Below, you'll find our key legislative priorities for 2025 that we urge policymakers to support. These legislative asks are crucial for ensuring that pathologists can continue to provide high-quality care and accurate diagnoses, ultimately improving patient outcomes. We appreciate your support and collaboration in advancing these important issues.

  • Medicare Payment Reform

    1. MEI Inflationary Update: Support legislation that provides an inflationary update using the Medicare Economic Index (MEI) to the Medicare Physician Fee Schedule.
    2. Budget Neutrality Requirements: Support changes to budget neutrality requirements, including:
      • Increasing the budget neutrality threshold.
      • Providing a lookback period to reconcile pricing adjustments.
      • Requiring timely updates to direct costs used to calculate Practice Expense Relative Value Units (RVUs).
      • Limiting positive or negative increases in the conversion factor to no greater than 2.5% each year.

  • Workforce

    1. Conrad 30 Waiver Program: Reauthorize the Conrad 30 waiver program, allowing non-U.S. international medical graduates (IMGs) to provide necessary patient care in underserved communities for at least three years before applying for an immigrant visa or permanent residence.
    2. Specialty Physicians Advancing Rural Care (SPARC) Act: Support the SPARC Act, which establishes a student loan repayment program to encourage specialty medical care in rural areas.
    3. Resident Education Deferred Interest (REDI) Act: Advocate for the REDI Act, a bipartisan bill that allows medical or dental interns and residents to defer student loan payments until the completion of their programs, with no interest accrual during residency.

  • Ongoing Legislative Priorities

    1. PAMA Reform: Seek a permanent solution to the flawed Protecting Access to Medicare Act (PAMA) that causes large cuts in the Medicare Clinical Laboratory Fee Schedule.
    2. LCD Reform: Urge Congress to pass legislation reforming the Medicare Local Coverage Determination (LCD) process to ensure coverage decisions are made by qualified health experts through a transparent process based on sound medical evidence.
    3. Medicaid: Advocate against cuts to the Medicaid program.
    4. Private Payer: Require adequate networks that include hospital/facility-based physicians, restrict in-network steering/tiering, maintain physician-led team-based care, ensure meaningful enforcement, and increase antitrust scrutiny. 
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