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ePolicy News January, 2012

Wednesday, January 4, 2012



Quest Advocates for Federal Funding for Laboratory Workforce Training

On Dec. 12, Senior Vice President and Chief Medical Officer of Quest Diagnostics, Jon R. Cohen, urged U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius to support funding to recruit and train clinical laboratory technologists to stem the growing workforce shortage. “We would like the administration to create a dedicated funding stream at the Department of Labor to attract and train lab techs. Specific lab tech training grants will help create middle class jobs, and allow companies like Quest Diagnostics to continue to create medical innovations that also help promote economic growth nationwide,” Cohen told a panel of healthcare leaders at a public roundtable discussion hosted by HHS Secretary Sebelius in New York City. The objective of the roundtable was to promote President Obama’s Council on Jobs and Competitiveness.

In his comments to Sebelius and the panel, Cohen proposed several possible funding avenues the administration could use to boost the nation’s capacity to attract and train laboratory professionals, including the President’s Fiscal Year 2013 Budget and existing Department of Labor grant programs.

The laboratory workforce shortage continues to be an issue of great concern as the nation’s aging population coupled with the emerging practice of personalized medicine is placing increased demands on our healthcare system. ASCP has long advocated for increased funding for laboratory training programs through the Department of Labor's Workforce Investment Act.

In addition, ASCP has made a Commitment to Action with the Clinton Global Initiative (CGI) on a project to alleviate the shortage of laboratory professionals. Expanding the Laboratory Workforce for the 21st Century is a five-year ASCP commitment to expand the capacity of the clinical laboratory workforce in the state of New York, with implications for future similar initiatives across the nation.

Congress Reaches Deal to Address Payroll Taxes, Doc Pay Fix

As 2011 drew to a close, the House of Representatives and Senate were still at odds over the payroll tax bill, which just also happened to be Congress’ vehicle to provide relief from the impending 27.4 percent cut in Medicare physician reimbursement rates and TC Grandfather provision (see related story). However, at the eleventh hour, Congress found a compromise to maintain present Medicare physician payment rates. The massive cut in reimbursement rates, which was scheduled to go into effect on Jan. 1, was the result of the annual updating of Medicare physician payment rates using the flawed sustainable growth rate (SGR)—the formula Congress crafted in 1997 to keep spending on Medicare physician services from growing at a rate faster than the overall U.S. economy.

The extension expires at the end of February, at which time lawmakers will have to come up with a longer-term solution extending these provisions. The last-minute Congressional compromise also extended the payroll tax cut and unemployment insurance benefits.

As the compromise was being hammered out, the Senate in mid-December approved legislation extending the payroll tax by two months to allow Congress to come to agreement on a longer-term extension of the payroll tax. That bill would also have forestalled any cuts in Medicare physician reimbursement rates by two months. The House, however, refused to agree to the Senate bill, instead calling for immediate negotiations for a lengthier fix. The House favored a two-year fix, embraced in a bill it approved on Dec. 13, while the Senate preferred a one-year fix. That said, the primary issues concerned offsets (budget cuts) and other policy issues unrelated to the SGR. A two-year fix would have cost $38 billion while a one-year fix would have cost $21 billion.

Though Congress has had to step in to prevent SGR-related cuts from reducing the physician reimbursement rates every year since 2003, the reason Congress has not approved a real fix to the flawed formula is cost: a permanent fix would cost approximately $300 billion. Because of these costs, Congress has limited its interventions to fixes generally lasting less than two years.

IOM Report Addresses Allied Health Workforce and Services

In light of healthcare reform, the role of allied health professionals is increasingly becoming invaluable and essential in the future of healthcare delivery. On Dec. 21, the IOM released its workshop summary from the May 2011 meeting to reflect the opinion of the presenters on the current climate in the allied healthcare workforce and the profession’s contribution to the improvement of healthcare access, quality, and effectiveness in the future. The major themes discussed at the workshop include data collection and analysis; education and training; practice issues; and the future of allied health. These issues will help “to better inform workforce planning and allocation of resources in the states,” according to Susan Chapman, PhD, RN, Associate Professor in the University of California San Francisco (UCSF) School of Nursing. As the nation ages, the demand for health care is on the rise. Along with the rest of the allied health professionals, medical laboratory personnel will be crucial to the future of the nation’s health.

Click on the link for a copy of the report: 



ASCP, AIM Pressing for Reform of Self-Referral Law for Pathology Services

The American Society for Clinical Pathology recently signed on to an Alliance for Integrity in Medicare (AIM) letter to key leaders in Congress as part of an effort to remove pathology services from the Stark Law’s In-office Ancillary Services (IOAS) Exception. The IOAS Exception outlines exceptions, or safe harbors, to the Stark Law’s ban on the self-referral of physician services. Removing pathology services from the exemption is intended to prevent inappropriate self-referral and potentially abusive billing of pathology services.

AIM is a coalition of organizations dedicated to ending the practice of inappropriate physician self-referral in Medicare. ASCP is a founding member of the coalition. Other members of AIM representing the specialty of pathology and laboratory medicine are the American Clinical Laboratory Association (ACLA) and the College of American Pathologists (CAP). ASCP is pleased to be a member of the coalition and to have the opportunity to work side-by-side with our colleagues at ACLA and CAP.

ASCP is also pleased to work with a recent addition to ACLA’s staff, Francesca Fierro O'Reilly, who has been lending her leadership and strategic advocacy skills to the coalition. Fierro O’Reilly is a seasoned healthcare advocate and has worked for the American Health Care Association as a Government Relations Director, as well as other healthcare organizations, such as the American Association of Colleges of Nursing and the Parkinson’s Action Network, after working as a Congressional staffer for years. That said, her “training” in health care precedes her professional work, as a family member is an ASCP member!

ASCP Joins CAP to Push for TC Grandfather Extension

ASCP, the College of American Pathologists, and other organizations representing laboratories, laboratory professionals, and physicians wrote leaders of the Senate Finance Committee and the House Ways & Means Committee to urge that they extend an expiring provision that would ensure hospitals can continue to rely on independent laboratories to provide surgical pathology services to patients without disruption, increased costs, and additional administrative burdens. The provision was extended in Congressional action lasting through February.

Since the inception of Medicare independent laboratories have received direct payments from Medicare for both the technical component (TC) and the professional component (PC) of laboratory tests. However, since 2001, Congress, through a “grandfather” provision, has curbed implementation of a CMS regulation that would eliminate direct payments for the TC portion of these diagnostic services provided to hospital patients.

The “grandfather” applies to services delivered to any hospital that used an independent laboratory for surgical pathology TC services as of July 22, 1999. Most recently, as part of the Medicare and Medicaid Extenders Act of 2010, Congress maintained the “grandfather” through Dec. 31, 2011. However, without further congressional action, this protection would have expired at the end of 2011, impacting billing systems and procedures, and limiting patient access to important medical testing.



The Joint Commission Seeks Input on Proposed Patient Safety Goal

The Joint Commission is seeking comments on a proposed National Patient Safety Goal (NPSG), addressing the overuse of various treatments, procedures, and tests for Hospital and Critical Access Hospital accreditation programs. As written, laboratories would not be part of this NPSG evaluation process. The Commission defines overuse as the use of a health service in circumstances where the likelihood of benefit is negligible and, therefore, the patient faces only the risk of harm. Seen from this perspective, overuse is a safety and quality problem. Additionally, research has demonstrated that overuse occurs with significant frequency in the United States.

To address this serious safety and quality problem, The Joint Commission is proposing a new NPSG on the topic of overuse and is seeking input from the field. ASCP’s Commission on Public Policy & Government Relations recently weighed in favorably on the proposed goal as patient safety is among the Society’s key public policy priorities. However, The Joint Commission would like to hear from ASCP’s entire membership. This NPSG is open for field review and comment through Jan. 24, 2012: Please review the goal, and then provide comments using one of the methods listed below.

Step 1: Read the Proposed Standards

Step 2: Provide Your Comments
Tell us what you think. You can submit your comments in one of the following ways:

  • Submit your comments via the online survey, which will take approximately eight minutes to complete.
  • Submit your comments via the online form.
  • Submit your comments via mail.

The Joint Commission
Standards and Survey Methods
Proposed NPSG on Health Care Overuse
One Renaissance Blvd.
Oakbrook Terrace, IL 60181

Conference Focuses on Patient-Centeredness in Policy and Practice

ASCP participated in the conference organized by ECRI Institute entitled “Patient-Centeredness in Policy and Practice: A conference on evidence, programs, and implications.” The two-day conference, Nov. 29–30, addressed ways to successfully implement patient-centeredness in healthcare delivery. Participants include individuals from the government, academia, and healthcare fields. The policy discussion among the leaders of key Federal agencies included finding balance between population health and patient health, using science data and evidence as a driving force in regulating patient-centeredness, and engaging various communities to improve care and outcomes for everyone. The meeting also had a session on the role of patient-centeredness in the Affordable Care Act and in regulations. There were suggestions on including patients as part of the governing boards to increase patient engagement in health law and regulations.

The climate in healthcare delivery is moving from medical care to the home environment. Jeffrey Shuren, MD, JD, Director of the Center for Devices and Radiological Health, U.S Food and Drug Administration (FDA), provided an FDA perspective on the critical role that patients play in the life cycle of medical products. It included expanding opportunities for patients to report to the FDA and understanding individual patient experiences with technologies they utilize. ASCP has been monitoring developments on the topic of premarket review of medical devices. Furthermore, ASCP supports comparative effectiveness research to drive a successful partnership between research teams and patients in the community.

For more information on the meeting, click here: 


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