Previous Advocacy Updates

A US Court of Appeals ruled in the CAP’s favor by reversing a lower court decision and stating that federal courts do have jurisdiction to decide the merits of a challenge to the federal government’s administration of PAMA.

The CMS released the proposed 2020 Medicare physician fee schedule with some changes to the evaluation and management (E/M) payments. The CMS proposed an increase payment for E/M office visit services for primary care and decrease for all other specialty services and procedures, including pathology services.

The CAP urged the CMS to provide regulatory relief on several issues that affect pathologists, including prior authorization, rural health care access, evaluation and management services, and timely regulation communication.

Because of the CAP’s advocacy, the CMS will increase reimbursements for CAR T-cell therapies in 2020.

Since April, the CAP has urged Anthem to reverse the new policy given the serious negative impacts on pathologists and patients’ access to pathology services.

Key CAP leaders urged the Anthem to reverse cuts to pathology services the insurer has rolled out in multiple states.

Since April, the CAP has urged Anthem to reverse the new policy given the serious negative impacts on pathologists and patients’ access to pathology services.

More than 1,000 pathologists have chosen the Pathologists Quality Registry for the 2019 performance year.

The CAP strongly urged CMS to reconsider and abandon cuts to pathology payments in the proposed 2020 Medicare Physician Fee Schedule.

The CAP firmly stated concerns about proposals from the CMS to develop new bundled payments and emphasized its concerns around the Stark law.

The CAP strongly opposed the CMS decision to remove the autopsy standards for hospitals. With this regulation change, hospitals are no longer required to have autopsy programs to qualify for Medicare reimbursement.

The CAP monitors latest house committee solution for surprise medical bills. In a recent letter to committee members, the House Ways and Means Committee Chairman Richard Neal (D-MA) proposed a different approach to end surprise medical bills through the regulatory rulemaking process.

The CAP is urging its membership to directly contact government officials with their concerns for removing the requirement of an autopsy program as a condition for hospital participation in Medicare.

The CAP, along with other physician specialties, applauded Reps. Raul Ruiz, MD (D-CA) and Phil Roe, MD (R-TN) for gaining 100 cosponsors for their bipartisan surprise medical bill legislation.

CAP members met with congressional offices and urged them to back a fair payment formula and arbitration process when physicians’ services are unexpectedly provided out of network to patients.

The CAP will fight the sharp Medicare cuts to Pathologists finalized in 2020 Fee Schedule, while it did succeed in protecting pathology reporting measures.

The CAP, the American Medical Association, and 100 other medical societies raised concerns in a recent letter to the Secretary of the Department of Health and Human Services regarding a proposal to loosen current Medicare scope of practice restraints.

The CAP participated at the Clinical Laboratory Improvement Advisory Committee and sought to ensure regulations keep up with emerging technologies.

At the 2019 AMA Interim Meeting, the CAP advocated to reinstate autopsy hospital standard and pushes back on step therapy protocols.