What States Require Out of State Liscense When Reading Patholog
May seven, 2019
In This Consequence:
- Pathologists Advocate to Protect Patients from Surprise Medical Bills; Urge PAMA Reform
- CMS Reopens NGS National Coverage Determination After CAP Concerns
- Anthem BCBS Revising Fee Schedules for Pathology Services in Several States
- CAP Notches Victory with North Dakota Beak on Out-of-Land Pathology Consults
- 2019 Practice Characteristics Survey Is Open
Pathologists Advocate to Protect Patients from Surprise Medical Bills; PAMA Reform
CAP Members get set up to see with their Federal legislators at the 2019 CAP Colina Day.
CAP members made an impact on health policy by meeting with their federal legislators to advocate for patients and the pathology specialty on May 1 in Washington, DC. During the CAP'south annual Hill Day, more than 80 pathologists discussed how Congress could protect patients from surprise medical bills and improve how Medicare reimburses clinical laboratory tests.
About 160 meetings with congressional offices, pathologists advocated to amend the Protecting Admission to Medicare Act of 2014 (PAMA) to reflect an accurate, market-based payment organization for laboratories paid through the clinical laboratory fee schedule. CAP members besides reviewed how the CAP can assist protect patients from surprise medical billing disputes, ensure network adequacy, and if an out-of-network physician provides services to a patient, fairly compensate that doctor for the services provided.
If yous couldn't make information technology to Washington this year, you lot tin can nonetheless make a difference from your home or office!
Jennifer Forsyth, Physician, FCAP meets with Sen. John Boozman, (AR-R)
Visit the CAP's advocacy action centre to back up our advocacy on surprise billing. It's easy and takes little time to abet on the issues impacting how y'all do and your ability to provide patients with quality care.
Join PathNET and visit the action eye today.
CMS Reopens NGS National Coverage Determination After CAP Expresses Concerns
Subsequently strong comments from the CAP, likewise equally several industry stakeholders, the Centers for Medicare & Medicaid Services (CMS) formally announced that information technology re-opened its national coverage determination (NCD) for side by side-generation sequencing (NGS) panels. The action followed stakeholder concerns regarding Medicare'south implementation of the NCD. The CAP had urged the CMS to alter its NCD policy implementation on NGS for patients with advanced cancer.
The CMS is only reconsidering the evidence available for tests of germline mutations to place those patients with hereditary cancer who may do good from targeted treatments based on results of the test. All other tests are beyond the telescopic of this reconsideration. The CMS is interested in collecting feedback that includes scientific evidence and addresses the scope of this reconsideration.
In a Jan 28 letter of the alphabet to the CMS, the CAP, and other stakeholders asked the CMS to revise its current estimation of the NCD by limiting it to somatic tumor testing and to communicate this alter to the MACs. The letter was in response to the CMS' interpretation that the NCD will apply to both somatic and germline NGS-based testing for late-stage cancers. The final NCD was widely interpreted by manufacture to utilize only to somatic tumor testing.
The CMS has asked for comments past May 29. The CAP will continue to engage with the agency on this issue.
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Anthem BCBS Revising Fee Schedules for Pathology Services in Several States
The CAP is aware of fee schedule changes existence implemented by Anthem Blue Cross and Blueish Shield that may result in reductions to pathology services.
The reimbursement policy affects, or will soon affect, Canticle's commercial and Medicare Advantage insurance products in states such as Alaska, California, Indiana, Missouri, and Ohio. Pathology practices in these states have been receiving letters and other communications most the new fee schedule from the insurer. For example, a notification to physicians in Indiana is published online.
Anthem asks physicians with questions about the fee schedule change to contact their regional network director for boosted data.
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CAP Notches Victory with North Dakota Neb on Out-of-State Pathology Consults
Considering of one CAP fellow member's advocacy, North Dakota Gov. Doug Burgum signed into police force legislation that effectively allows patients to receive second opinions from out-of-state pathologists and physicians without the requirement for state licensure. This marks the first legislative victory for the CAP in the country of North Dakota.
Mary Ann Sens, Md, PhD, FCAP, chair of the Department of Pathology at the University of N Dakota and a CAP State Issue Advisor, is credited with leading passage of the legislation on behalf of the CAP and pathologists across the land. CAP leaders cited Dr. Sens' advancement every bit an example of how just one pathologist can advance the exercise of pathology in a country.
Prior to passage of SB 2094, consultations by out-of-land physicians had to be completed within 24 hours, which precluded any out-of-country pathologist 2nd stance on a pathology diagnosis. The measure, which sets new standards for telemedicine, extends the period for a one-time fourth dimension consultation by an out-of-state physician on a diagnosis for a country resident from 24 hours to seven days.
The CAP has long held that a pathologist who engages in the interstate exercise of pathology, including telepathology, and problems a diagnosis should have a total, unrestricted license to practice medicine from the state in which the patient presents for diagnosis, or where the specimen is taken or image is made. Of note, the CAP maintains that intra-specialty consultation from an out-of-state pathologist should non require in-state licensure provided that the consultation is at the request of an in-state pathologist licensed inside the state.
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2019 Do Characteristics Survey Is Open
The CAP 2019 Practise Characteristics Survey is underway, and you tin help by providing data from your pathology practice regarding your economic, demographic, and marketplace trend data in the evolving business organization surround. The survey is open until May 17.
Respondents are eligible for a cartoon for either one of three Amazon souvenir cards or Apple Watch® Serial iv wrist-clothing device. A winner was selected this calendar week, but you can still accept the survey and exist eligible for a prize next week. Pathologists who respond to the survey will take early access to survey results via an exclusive webinar.
If you take not received your invitation, delight contact us at practicesurvey@cap.org. This survey is available to lath-certified pathologists who are currently practicing in the US. The survey excludes total-fourth dimension retirees, pathologists practicing in dissimilar countries, and junior members of the CAP.
The survey should non accept more than 15 minutes to complete. The CAP will share the survey findings with its members in a full report and provide early access to the data to those who finish the survey. If you lot take not received your invitation, y'all can accept the survey.
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Source: https://www.cap.org/advocacy/latest-news-and-practice-data/may-7-2019
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