ADVOCACY EFFORTS

ADVOCACY EFFORTS

ADVOCACY EFFORTS

bg_image_bar_mobile

“The CAP continues to ensure pathologists can optimize Medicare reimbursement potential and demonstrate the quality of their practices.”

Emily E. Volk, MD, MBA, FCAP

“The CAP continues to ensure pathologists can optimize Medicare reimbursement potential and demonstrate the quality of their practices.”

Emily E. Volk, MD, MBA, FCAP

“The CAP continues to ensure pathologists can optimize Medicare reimbursement potential and demonstrate the quality of their practices.”

Emily E. Volk, MD, MBA, FCAP

Pathologists Protect Their Practices and Patients

Helping Pathologists Thrive in Medicare’s Quality Programs

With Medicare’s Quality Payment Program estimated to have a $2 billion impact on the pathology specialty, the CAP provided ways for pathologists to effectively participate in the Merit-based Incentive Payment System (MIPS) while also reducing the complexity and burden of data collection and reporting. “The CAP continues to ensure pathologists can optimize Medicare reimbursement potential and demonstrate the quality of their practices,” said Council on Government and Professional Affairs Vice Chair Emily E. Volk, MD, MBA, FCAP. “The 2017 launch of the Pathologists Quality Registry was a pivotal achievement for pathologists on this front.”

The Pathologists Quality Registry, CMS approved and powered by the leading specialty registry vendor FIGmd, is the first pathologist-specific qualified clinical data registry with additional, exclusive pathology measures. Pathologists began signing up for the registry following CAP17, the CAP’s annual meeting.

The Pathologists Quality Registry offers both manual data entry and data integration options for pathology practices. Advocacy efforts by the CAP have ensured pathologists can participate and have flexibility in Quality Payment Programs (QPP) in 2017 and beyond. Here are four initiatives the CAP has accomplished to help pathologists meet performance requirements:

  • Created the 2017 MIPS Reporting Solution for pathologists to fully comply with MIPS requirements and realize full reimbursement potential. More than 850 pathologists took advantage of the reporting tool.
  • Secured inclusion of eight additional pathology quality measures developed by the CAP for pathologists to report under MIPS’s quality category.
  • Identified the relevant improvement activities pathologists can attest to for MIPS. To make it easier to comply, we identified the relevant improvement activities pathologists can attest to for MIPS.
  • Advocated for fair MIPS performance scoring so pathologists are not disadvantaged due to the unique circumstances of the pathology practice setting.

Quality measure development is critically important for physicians to be successful in the changing payment environment. Through the years pathologists have used CAP-developed measures to earn $25 million in additional performance bonuses from the Medicare program. These same measures developed by the CAP have helped pathologists avoid roughly $30 million in penalties annually. The CAP will be offering new pathologist-developed, CMS-approved measures as part of its registry every year going forward.

As part of its advocacy strategy, the CAP also has developed resources to assist practices in succeeding with new requirements under MIPS, which is the default track for most physicians. The following pathology-specific educational materials were produced to help pathologists understand the new payment rules, reduce the burden of complying, and position their practices to maximize Medicare bonus potential and demonstrate quality:

  • Readiness Checklist for Pathologists
  • Making Sense of Medicare Access and CHIP Reauthorization Act (MACRA) Video
  • MIPS Financial Impact Calculator
  • MIPS FAQs and Webinars
  • Options for Reporting Improvement Activities

Through our advocacy efforts, pathologists are estimated to receive $5 million in Medicare incentive payments in 2018.

Medicare Payments to Pathologists by CMS Regulatory Cycle

Through our advocacy to protect the value of pathology services, overall Medicare payments to pathologists are projected to increase between 2017 and 2018. Due to the CAP’s engagement with the CMS and other stakeholders, our advocacy achieved positive changes, resulting in increases in payment for pathology services between the proposed and final Medicare Physician Fee Schedule (PFS) rulemakings (see graph). Without the CAP’s advocacy on Medicare payment, it was estimated that reimbursements from Medicare to pathologists in the final rules would have been $15 million lower over the two years.

The CAP’s impact can be seen in the changes to specific pathology services. Here are examples of the CAP’s efforts to increase, maintain, or mitigate decreases to reimbursements:

  • The CMS accepted the CAP’s recommendations for the physician work relative value units for six therapeutic apheresis codes. The services were identified as potentially misvalued, meaning Medicare could have cut payment rates for those services. However, payment to pathologists for therapeutic apheresis will increase in 2018 thanks to the CAP’s efforts.
  • The CAP also successfully defended against potential reimbursement decreases to pathology consultation during surgery services, which also were targeted for revaluation after being marked potentially misvalued. In the 2018 PFS Final Rule, the values for the services were maintained.
  • Last year, the CMS finalized cuts to flow cytometry services to be phased in over time. The CAP provided additional information to the CMS to reinstate some of flow cytometry’s value. As a result, the CMS reexamined direct practice expense inputs and finalized several of the CAP’s recommended changes to flow cytometry. The CAP will continue to engage with the Medicare agency on the value of flow cytometry services to ensure that the services are appropriately reimbursed.

Pathologists Protect Their Practices and Patients

Helping Pathologists Thrive in Medicare’s Quality Programs

With Medicare’s Quality Payment Program estimated to have a $2 billion impact on the pathology specialty, the CAP provided ways for pathologists to effectively participate in the Merit-based Incentive Payment System (MIPS) while also reducing the complexity and burden of data collection and reporting. “The CAP continues to ensure pathologists can optimize Medicare reimbursement potential and demonstrate the quality of their practices,” said Council on Government and Professional Affairs Vice Chair Emily E. Volk, MD, MBA, FCAP. “The 2017 launch of the Pathologists Quality Registry was a pivotal achievement for pathologists on this front.”

The Pathologists Quality Registry, CMS approved and powered by the leading specialty registry vendor FIGmd, is the first pathologist-specific qualified clinical data registry with additional, exclusive pathology measures. Pathologists began signing up for the registry following CAP17, the CAP’s annual meeting.

The Pathologists Quality Registry offers both manual data entry and data integration options for pathology practices. Advocacy efforts by the CAP have ensured pathologists can participate and have flexibility in Quality Payment Programs (QPP) in 2017 and beyond. Here are four initiatives the CAP has accomplished to help pathologists meet performance requirements:

  • Created the 2017 MIPS Reporting Solution for pathologists to fully comply with MIPS requirements and realize full reimbursement potential. More than 850 pathologists took advantage of the reporting tool.
  • Secured inclusion of eight additional pathology quality measures developed by the CAP for pathologists to report under MIPS’s quality category.
  • Identified the relevant improvement activities pathologists can attest to for MIPS. To make it easier to comply, we identified the relevant improvement activities pathologists can attest to for MIPS.
  • Advocated for fair MIPS performance scoring so pathologists are not disadvantaged due to the unique circumstances of the pathology practice setting.

Quality measure development is critically important for physicians to be successful in the changing payment environment. Through the years pathologists have used CAP-developed measures to earn $25 million in additional performance bonuses from the Medicare program. These same measures developed by the CAP have helped pathologists avoid roughly $30 million in penalties annually. The CAP will be offering new pathologist-developed, CMS-approved measures as part of its registry every year going forward.

As part of its advocacy strategy, the CAP also has developed resources to assist practices in succeeding with new requirements under MIPS, which is the default track for most physicians. The following pathology-specific educational materials were produced to help pathologists understand the new payment rules, reduce the burden of complying, and position their practices to maximize Medicare bonus potential and demonstrate quality:

  • Readiness Checklist for Pathologists
  • Making Sense of Medicare Access and CHIP Reauthorization Act (MACRA) Video
  • MIPS Financial Impact Calculator
  • MIPS FAQs and Webinars
  • Options for Reporting Improvement Activities

Through our advocacy efforts, pathologists are estimated to receive $5 million in Medicare incentive payments in 2018.

Medicare Payments to Pathologists by CMS Regulatory Cycle

Through our advocacy to protect the value of pathology services, overall Medicare payments to pathologists are projected to increase between 2017 and 2018. Due to the CAP’s engagement with the CMS and other stakeholders, our advocacy achieved positive changes, resulting in increases in payment for pathology services between the proposed and final Medicare Physician Fee Schedule (PFS) rulemakings (see graph). Without the CAP’s advocacy on Medicare payment, it was estimated that reimbursements from Medicare to pathologists in the final rules would have been $15 million lower over the two years.

The CAP’s impact can be seen in the changes to specific pathology services. Here are examples of the CAP’s efforts to increase, maintain, or mitigate decreases to reimbursements:

  • The CMS accepted the CAP’s recommendations for the physician work relative value units for six therapeutic apheresis codes. The services were identified as potentially misvalued, meaning Medicare could have cut payment rates for those services. However, payment to pathologists for therapeutic apheresis will increase in 2018 thanks to the CAP’s efforts.
  • The CAP also successfully defended against potential reimbursement decreases to pathology consultation during surgery services, which also were targeted for revaluation after being marked potentially misvalued. In the 2018 PFS Final Rule, the values for the services were maintained.
  • Last year, the CMS finalized cuts to flow cytometry services to be phased in over time. The CAP provided additional information to the CMS to reinstate some of flow cytometry’s value. As a result, the CMS reexamined direct practice expense inputs and finalized several of the CAP’s recommended changes to flow cytometry. The CAP will continue to engage with the Medicare agency on the value of flow cytometry services to ensure that the services are appropriately reimbursed.

Pathologists Protect Their Practices and Patients

Helping Pathologists Thrive in Medicare’s Quality Programs

With Medicare’s Quality Payment Program estimated to have a $2 billion impact on the pathology specialty, the CAP provided ways for pathologists to effectively participate in the Merit- based Incentive Payment System (MIPS) while also reducing the complexity and burden of data collection and reporting.

“The CAP continues to ensure pathologists can optimize Medicare reimbursement potential and demonstrate the quality of their practices,” said Council on Government and Professional Affairs Vice Chair Emily E. Volk, MD, MBA, FCAP. “The 2017 launch of the Pathologists Quality Registry was a pivotal achievement for pathologists on this front.”

The Pathologists Quality Registry, CMS approved and powered by the leading specialty registry vendor FIGmd, is the first pathologist-specific qualified clinical data registry with additional, exclusive pathology measures. Pathologists began signing up for the registry following CAP17, the CAP’s annual meeting.

The Pathologists Quality Registry offers both manual data entry and data integration options for pathology practices. Advocacy efforts by the CAP have ensured pathologists can participate and have flexibility in Quality Payment Programs (QPP) in 2017 and beyond. Here are four initiatives the CAP has accomplished to help pathologists meet performance requirements:

  • Created the 2017 MIPS Reporting Solution for pathologists to fully comply with MIPS requirements and realize full reimbursement potential. More than 850 pathologists took advantage of the reporting tool.
  • Secured inclusion of eight additional pathology quality measures developed by the CAP for pathologists to report under MIPS’s quality category.
  • Identified the relevant improvement activities pathologists can attest to for MIPS. To make it easier to comply, we identified the relevant improvement activities pathologists can attest to for MIPS.
  • Advocated for fair MIPS performance scoring so pathologists are not disadvantaged due to the unique circumstances of the pathology practice setting.

Quality measure development is critically important for physicians to be successful in the changing payment environment. Through the years pathologists have used CAP- developed measures to earn $25 million in additional performance bonuses from the Medicare program. These same measures developed by the CAP have helped pathologists avoid roughly $30 million in penalties annually. The CAP will be offering new pathologist-developed, CMS-approved measures as part of its registry every year going forward.

As part of its advocacy strategy, the CAP also has developed resources to assist practices in succeeding with new requirements under MIPS, which is the default track for most physicians. The following pathology-specific educational materials were produced to help pathologists understand the new payment rules, reduce the burden of complying, and position their practices to maximize Medicare bonus potential and demonstrate quality:

  • Readiness Checklist for Pathologists
  • Making Sense of Medicare Access and CHIP Reauthorization Act (MACRA) Video
  • MIPS Financial Impact Calculator
  • MIPS FAQs and Webinars
  • Options for Reporting Improvement Activities

Through our advocacy efforts, pathologists are estimated to receive $5 million in Medicare incentive payments in 2018.

Medicare Payments to Pathologists by CMS Regulatory Cycle

Through our advocacy to protect the value of pathology services, overall Medicare payments to pathologists are projected to increase between 2017 and 2018. Due to the CAP’s engagement with the CMS and other stakeholders, our advocacy achieved positive changes, resulting in increases in payment for pathology services between the proposed and final Medicare Physician Fee Schedule (PFS) rulemakings (see graph). Without the CAP’s advocacy on Medicare payment, it was estimated that reimbursements from Medicare to pathologists in the final rules would have been $15 million lower over the two years.

The CAP’s impact can be seen in the changes to specific pathology services. Here are examples of the CAP’s efforts to increase, maintain, or mitigate decreases to reimbursements:

  • The CMS accepted the CAP’s recommendations for the physician work relative value units for six therapeutic apheresis codes. The services were identified as potentially misvalued, meaning Medicare could have cut payment rates for those services. However, payment to pathologists for therapeutic apheresis will increase in 2018 thanks to the CAP’s efforts.
  • The CAP also successfully defended against potential reimbursement decreases to pathology consultation during surgery services, which also were targeted for revaluation after being marked potentially misvalued. In the 2018 PFS Final Rule, the values for the services were maintained.
  • Last year, the CMS finalized cuts to flow cytometry services to be phased in over time. The CAP provided additional information to the CMS to reinstate some of flow cytometry’s value. As a result, the CMS reexamined direct practice expense inputs and finalized several of the CAP’s recommended changes to flow cytometry. The CAP will continue to engage with the Medicare agency on the value of flow cytometry services to ensure that the services are appropriately reimbursed.

Advocacy Action on Local Coverage Determination (LCD) Reform

At the start of the 115th Congress, the CAP pursued and achieved the reintroduction of the Local Coverage Determination Clarification Act in the US House of Representatives and Senate. By the end of 2017, support for the legislation had gained 57 congressional sponsors…and counting.

Senators first reintroduced this key piece of legislation, with Sens. Johnny Isakson (R-GA), Tom Carper (D-DE), Debbie Stabenow (D-MI), and John Boozman (R-AR) as leading sponsors for the bipartisan bill. CAP members followed with a major push for additional sponsors during the 2017 Policy Meeting in May when 80 CAP members lobbied their elected officials during 139 meetings on Capitol Hill. Specifically, pathologists asked representatives and senators to support fixing the flawed LCD process by increasing transparency and accountability. The bill was later reintroduced in the House by Reps. Lynn Jenkins (R-KS) and Ron Kind (D-WI) as lead cosponsors.

Advocacy was further augmented by 464 CAP members sending 2,132 emails to their representatives in Congress through the CAP’s grassroots program, PathNET.

Our political action committee, PathPAC, kept pathologists’ messages visible and in central focus throughout the year. During the 2017 cycle, PathPAC donated over $233,000 to members of key congressional committees with jurisdiction over health care policy. CAP members also attended nine events with members of Congress and hosted fundraisers raising $54,000. Furthermore, 11 pathologists took part in a fall Hill Day during CAP17 to meet with 30 congressional offices and their staff.

As of December 2017, 42 House representatives and 15 senators sponsored the Local Coverage Determination Clarification Act of 2017.

Advocacy Action on Local Coverage Determination (LCD) Reform

At the start of the 115th Congress, the CAP pursued and achieved the reintroduction of the Local Coverage Determination Clarification Act in the US House of Representatives and Senate. By the end of 2017, support for the legislation had gained 57 congressional sponsors…and counting.

Senators first reintroduced this key piece of legislation, with Sens. Johnny Isakson (R-GA), Tom Carper (D-DE), Debbie Stabenow (D-MI), and John Boozman (R-AR) as leading sponsors for the bipartisan bill. CAP members followed with a major push for additional sponsors during the 2017 Policy Meeting in May when 80 CAP members lobbied their elected officials during 139 meetings on Capitol Hill. Specifically, pathologists asked representatives and senators to support fixing the flawed LCD process by increasing transparency and accountability. The bill was later reintroduced in the House by Reps. Lynn Jenkins (R-KS) and Ron Kind (D-WI) as lead cosponsors.

Advocacy was further augmented by 464 CAP members sending 2,132 emails to their representatives in Congress through the CAP’s grassroots program, PathNET.

Our political action committee, PathPAC, kept pathologists’ messages visible and in central focus throughout the year. During the 2017 cycle, PathPAC donated over $233,000 to members of key congressional committees with jurisdiction over health care policy. CAP members also attended nine events with members of Congress and hosted fundraisers raising $54,000. Furthermore, 11 pathologists took part in a fall Hill Day during CAP17 to meet with 30 congressional offices and their staff.

As of December 2017, 42 House representatives and 15 senators sponsored the Local Coverage Determination Clarification Act of 2017.

Advocacy Action on Local Coverage Determination (LCD) Reform

At the start of the 115th Congress, the CAP pursued and achieved the reintroduction of the Local Coverage Determination Clarification Act in the US House of Representatives and Senate. By the end of 2017, support for the legislation had gained 57 congressional sponsors…and counting.

Senators first reintroduced this key piece of legislation, with Sens. Johnny Isakson (R-GA), Tom Carper (D-DE), Debbie Stabenow (D-MI), and John Boozman (R-AR) as leading sponsors for the bipartisan bill. CAP members followed with a major push for additional sponsors during the 2017 Policy Meeting in May when 80 CAP members lobbied their elected officials during 139 meetings on Capitol Hill. Specifically, pathologists asked representatives and senators to support fixing the flawed LCD process by increasing transparency and accountability. The bill was later reintroduced in the House by Reps. Lynn Jenkins (R-KS) and Ron Kind (D-WI) as lead cosponsors.

Advocacy was further augmented by 464 CAP members sending 2,132 emails to their representatives in Congress through the CAP’s grassroots program, PathNET.

Our political action committee, PathPAC, kept pathologists’ messages visible and in central focus throughout the year. During the 2017 cycle, PathPAC donated over $233,000 to members of key congressional committees with jurisdiction over health care policy. CAP members also attended nine events with members of Congress and hosted fundraisers raising $54,000. Furthermore, 11 pathologists took part in a fall Hill Day during CAP17 to meet with 30 congressional offices and their staff.

As of December 2017, 42 House representatives and 15 senators sponsored the Local Coverage Determination Clarification Act of 2017.

Advocacy Action on Local Coverage Determination (LCD) Reform

At the start of the 115th Congress, the CAP pursued and achieved the reintroduction of the Local Coverage Determination Clarification Act in the US House of Representatives and Senate. By the end of 2017, support for the legislation had gained 57 congressional sponsors…and counting.

Senators first reintroduced this key piece of legislation, with Sens. Johnny Isakson (R-GA), Tom Carper (D-DE), Debbie Stabenow (D-MI), and John Boozman (R-AR) as leading sponsors for the bipartisan bill. CAP members followed with a major push for additional sponsors during the 2017 Policy Meeting in May when 80 CAP members lobbied their elected officials during 139 meetings on Capitol Hill. Specifically, pathologists asked representatives and senators to support fixing the flawed LCD process by increasing transparency and accountability. The bill was later reintroduced in the House by Reps. Lynn Jenkins (R-KS) and Ron Kind (D-WI) as lead cosponsors.

Advocacy was further augmented by 464 CAP members sending 2,132 emails to their representatives in Congress through the CAP’s grassroots program, PathNET.

Our political action committee, PathPAC, kept pathologists’ messages visible and in central focus throughout the year. During the 2017 cycle, PathPAC donated over $233,000 to members of key congressional committees with jurisdiction over health care policy. CAP members also attended nine events with members of Congress and hosted fundraisers raising $54,000. Furthermore, 11 pathologists took part in a fall Hill Day during CAP17 to meet with 30 congressional offices and their staff.

As of December 2017, 42 House representatives and 15 senators sponsored the Local Coverage Determination Clarification Act of 2017.

State Advocacy

To strengthen the profession of pathology, our strong partnerships with state pathology societies bolster advocacy efforts at the state level. The CAP actively worked together with state pathology societies on several important issues to pathologists and patients.

Our advocacy on network adequacy impacted a CMS application review process for qualified health plans (QHPs) seeking to be part of the federally facilitated insurance exchange in 2018. In April, the CMS announced a requirement that the plan document its method for monitoring access to hospital-based physician services, including services from pathologists. The requirement was transposed verbatim from state legislative language that the CAP initially proposed; and the requirement was adopted in the model network adequacy bill approved by the National Association of Insurance Commissioners (NAIC) in 2015.

The CAP successfully amended Wyoming legislation on informed consent for genetic testing to ensure no legal onus or impediment on pathologists performing these services.

In Kansas, the governor signed into law several negotiated amendments from the CAP and the Kansas Society of Pathologists to the direct billing law for anatomic pathology services. These amendments maintained the integrity of the law while making allowances for the practice of concierge medicine by primary care providers.

In 2017, the CAP, working with state pathology societies, successfully advocated against payment restrictions on out-of-network balance billing in more than a dozen states (Arkansas, Colorado, Connecticut, Georgia, Idaho, Indiana, Louisiana, Massachusetts, North Carolina, New Hampshire, New Jersey, Oregon, Pennsylvania, Rhode Island, Tennessee, Utah, and Washington).

Working with the Tennessee Society of Pathologists, the CAP successfully invoked the Tennessee direct billing law for anatomic pathology services to reverse actions by a health insurance payer to deny technical component payment.

The CAP helped defeat legislation in New Hampshire that would have allowed patients to order all forms of pathology and laboratory tests without ensuring that such tests were subject to proficiency testing.

2017 Practice Characteristics Survey

Pathologists received the results of the 2017 Practice Characteristics Survey, the tenth survey conducted by the CAP since 1994, during CAP17. A total of 1,601 pathologists completed the survey, including 1,124 CAP fellows. The survey provided a primary source of basic data on pathologists, how they practice, and how they are being compensated. It also tracked changes that are occurring in the workforce among CAP members. The survey report is one of several projects led by the CAP’s Policy Roundtable to study socioeconomics and compile data about the pathology profession. Responses from the survey help inform CAP policy and advocacy positions.

State Advocacy

To strengthen the profession of pathology, our strong partnerships with state pathology societies bolster advocacy efforts at the state level. The CAP actively worked together with state pathology societies on several important issues to pathologists and patients.

Our advocacy on network adequacy impacted a CMS application review process for qualified health plans (QHPs) seeking to be part of the federally facilitated insurance exchange in 2018. In April, the CMS announced a requirement that the plan document its method for monitoring access to hospital-based physician services, including services from pathologists. The requirement was transposed verbatim from state legislative language that the CAP initially proposed; and the requirement was adopted in the model network adequacy bill approved by the National Association of Insurance Commissioners (NAIC) in 2015.

The CAP successfully amended Wyoming legislation on informed consent for genetic testing to ensure no legal onus or impediment on pathologists performing these services.

In Kansas, the governor signed into law several negotiated amendments from the CAP and the Kansas Society of Pathologists to the direct billing law for anatomic pathology services. These amendments maintained the integrity of the law while making allowances for the practice of concierge medicine by primary care providers.

In 2017, the CAP, working with state pathology societies, successfully advocated against payment restrictions on out-of-network balance billing in more than a dozen states (Arkansas, Colorado, Connecticut, Georgia, Idaho, Indiana, Louisiana, Massachusetts, North Carolina, New Hampshire, New Jersey, Oregon, Pennsylvania, Rhode Island, Tennessee, Utah, and Washington).

Working with the Tennessee Society of Pathologists, the CAP successfully invoked the Tennessee direct billing law for anatomic pathology services to reverse actions by a health insurance payer to deny technical component payment.

The CAP helped defeat legislation in New Hampshire that would have allowed patients to order all forms of pathology and laboratory tests without ensuring that such tests were subject to proficiency testing.

2017 Practice Characteristics Survey

Pathologists received the results of the 2017 Practice Characteristics Survey, the tenth survey conducted by the CAP since 1994, during CAP17. A total of 1,601 pathologists completed the survey, including 1,124 CAP fellows. The survey provided a primary source of basic data on pathologists, how they practice, and how they are being compensated. It also tracked changes that are occurring in the workforce among CAP members. The survey report is one of several projects led by the CAP’s Policy Roundtable to study socioeconomics and compile data about the pathology profession. Responses from the survey help inform CAP policy and advocacy positions.

State Advocacy

To strengthen the profession of pathology, our strong partnerships with state pathology societies bolster advocacy efforts at the state level. The CAP actively worked together with state pathology societies on several important issues to pathologists and patients.

Our advocacy on network adequacy impacted a CMS application review process for qualified health plans (QHPs) seeking to be part of the federally facilitated insurance exchange in 2018. In April, the CMS announced a requirement that the plan document its method for monitoring access to hospital-based physician services, including services from pathologists. The requirement was transposed verbatim from state legislative language that the CAP initially proposed; and the requirement was adopted in the model network adequacy bill approved by the National Association of Insurance Commissioners (NAIC) in 2015.

The CAP successfully amended Wyoming legislation on informed consent for genetic testing to ensure no legal onus or impediment on pathologists performing these services.

In Kansas, the governor signed into law several negotiated amendments from the CAP and the Kansas Society of Pathologists to the direct billing law for anatomic pathology services. These amendments maintained the integrity of the law while making allowances for the practice of concierge medicine by primary care providers.

In 2017, the CAP, working with state pathology societies, successfully advocated against payment restrictions on out-of-network balance billing in more than a dozen states (Arkansas, Colorado, Connecticut, Georgia, Idaho, Indiana, Louisiana, Massachusetts, North Carolina, New Hampshire, New Jersey, Oregon, Pennsylvania, Rhode Island, Tennessee, Utah, and Washington).

Working with the Tennessee Society of Pathologists, the CAP successfully invoked the Tennessee direct billing law for anatomic pathology services to reverse actions by a health insurance payer to deny technical component payment.

The CAP helped defeat legislation in New Hampshire that would have allowed patients to order all forms of pathology and laboratory tests without ensuring that such tests were subject to proficiency testing.

2017 Practice Characteristics Survey

Pathologists received the results of the 2017 Practice Characteristics Survey, the tenth survey conducted by the CAP since 1994, during CAP17. A total of 1,601 pathologists completed the survey, including 1,124 CAP Fellows.

The survey provided a primary source of basic data on pathologists, how they practice, and how they are being compensated. It also tracked changes that are occurring in the workforce among CAP members. The survey report is one of several projects led by the CAP’s Policy Roundtable to study socioeconomics and compile data about the pathology profession. Responses from the survey help inform CAP policy and advocacy positions.

Advocacy Issues of Greatest Importance to Pathologists (N=1,284)

wdt_ID ISSUE % LISTED AS TOP PRIORITY % LISTED AS TOP 5 PRIORITIES
1 Medicare payment for pathology services 23 63
2 Changes to pathology's scope of practice 12 47
3 Direct billing for pathology services 10 39
4 Maintenance of Certification (MOC) requirements 7 34
5 Personalized/precision medicine, genomics 7 33
6 Food and Drug Administration regulations and oversight of laboratory-developed tests 7 33
9 Compliance with Medicare Quality Payment Programs 3 29
10 Funding for graduate medical education and training 3 25
11 Self-referral of anatomic pathology specimens 6 24
22 Local Coverage Determinations (LCDs) 3 22

Advocacy Issues of Greatest Importance to Pathologists (N=1,284)

wdt_ID ISSUE % LISTED AS TOP PRIORITY % LISTED AS TOP 5 PRIORITIES
1 Medicare payment for pathology services 23 63
2 Changes to pathology's scope of practice 12 47
3 Direct billing for pathology services 10 39
4 Maintenance of Certification (MOC) requirements 7 34
5 Personalized/precision medicine, genomics 7 33
6 Food and Drug Administration regulations and oversight of laboratory-developed tests 7 33
9 Compliance with Medicare Quality Payment Programs 3 29
10 Funding for graduate medical education and training 3 25
11 Self-referral of anatomic pathology specimens 6 24
22 Local Coverage Determinations (LCDs) 3 22

Advocacy Issues of Greatest Importance to Pathologists (N=1,284)

wdt_ID ISSUE % LISTED AS TOP PRIORITY % LISTED AS TOP 5 PRIORITIES
1 Medicare payment for pathology services 23 63
2 Changes to pathology's scope of practice 12 47
3 Direct billing for pathology services 10 39
4 Maintenance of Certification (MOC) requirements 7 34
5 Personalized/precision medicine, genomics 7 33
6 Food and Drug Administration regulations and oversight of laboratory-developed tests 7 33
9 Compliance with Medicare Quality Payment Programs 3 29
10 Funding for graduate medical education and training 3 25
11 Self-referral of anatomic pathology specimens 6 24
22 Local Coverage Determinations (LCDs) 3 22

STATLINE

CAP members received timely news and analysis following the release of major federal regulations through special alerts and weekly editions of STATLINE, the CAP’s award-winning online advocacy newsletter. STATLINE received an award for publication excellence in the 2017 APEX Awards’ electronic newsletter category.

STATLINE

CAP members received timely news and analysis following the release of major federal regulations through special alerts and weekly editions of STATLINE, the CAP’s award-winning online advocacy newsletter. STATLINE received an award for publication excellence in the 2017 APEX Awards’ electronic newsletter category.

STATLINE

CAP members received timely news and analysis following the release of major federal regulations through special alerts and weekly editions of STATLINE, the CAP’s award-winning online advocacy newsletter. STATLINE received an award for publication excellence in the 2017 APEX Awards’ electronic newsletter category.