Previous Advocacy Updates

In 2017, most pathologists will need to take action to stop penalties from reducing future Medicare payments for their services.

Medicare contractors have removed age restrictions from its coverage policy for the genetic testing of Lynch Syndrome after receiving a request by the CAP and American Gastroenterological Association.

The CAP will collaborate to develop protocols for collection, processing, and analysis of cancer blood samples as part of the Blood Profiling Atlas project within the "Cancer Moonshot" initiative.

Following concerns from the CAP and other organizations, the Medicare program will provide additional flexibility to physicians as it transitions to a new reimbursement system starting in 2017.

Following an initial launch of the laboratory benefit management program in Florida, an insurer announced it will expand the program to include its members enrolled in commercial plans in Texas.

The CAP welcomed the introduction of Senate bill 3392, the Local Coverage Determination Clarification Act, which would improve transparency and accountability when Medicare contractors LCDs.

The CMS released a template that applicable laboratories can use to report private payer rates and associated volume for CLFS services required under the PAMA's new payment system for laboratories.

Medicare should remove discounts applied to add-on codes for IHC and other services, the CAP advocated in its comments on the 2017 fee schedule.

Leading organizations representing pathologists have stated their strong support for the Local Coverage Determination Clarification Act (HR 5721).

The CAP engaged with the CMS to further clarify how physicians will use patient relationship categories and codes that are being developed under the new MIPS program.

The CMS has published a list of HCPCS codes for clinical laboratory tests that applicable laboratories will use to collect and report private payer data to the CMS.

The CMS published the first of its additional guidance documents to laboratories clarifying obligations regarding the collection and reporting of data under the Protecting Access to Medicare Act of 2014.

According to the latest experience report on the PQRS program, 86.3% of eligible pathologists earned a Medicare bonus by reporting quality measures developed by the CAP.

The CAP recommended national pricing for new genomic sequencing procedures and other laboratory test CPT codes under consideration in the 2017 Medicare clinical laboratory fee schedule (CLFS).

The CAP applauded the introduction of the Local Coverage Determination Clarification Act to improve transparency and accountability when Medicare contractors set LCD policies.

In the proposed 2017 Medicare Physician Fee Schedule, the CMS proposed to maintain value for several pathology codes targeted as misvalued. The CMS also proposed gains for add-on codes used for IHC and FISH services, which the CAP had strongly advocated for in 2014, 2015 and 2016.

The CAP advocated for several changes to the proposed MACRA regulation that reflect the value pathologists have on patient care and ensure pathologists can participate in the new payment programs.

The AMA House of Delegates approved a modernized Code of Medical Ethics, which concluded two years of work and deliberation on the code, including input from the CAP.

Health regulators in New York State have proposed to reverse a ban on pathologists discussing laboratory results with patients following two years of advocacy by the CAP and NYSSPATH.

Following a 2009 law enacted with support from the California Society of Pathologists (CSP) and the CAP, regulatory officials will now save laboratories in the state from duplicative oversight requirements.