Federal
ASCP Enhances Efforts to Tackle Lab Professional Workforce Issues
Stimulus Money Available But Will Require Community-Based Efforts
Part I: MT/CLS School Closures – Several Large Programs Slated to Close
The American Society for Clinical Pathology (ASCP) recently expanded its efforts to tackle the laboratory workforce shortage by advocating to prevent the closure of several Medical Technology/Clinical Laboratory Science training programs. ASCP believes the closure of these programs has a direct link to the workforce shortage as there are fewer opportunities to train and produce qualified laboratory personnel to step into slots being vacated by retiring professionals.
Among the schools that ASCP lent assistance is Arizona State University (ASU) and the University of South Alabama (USA). The Society launched a nationwide campaign, “Don’t Close the Door on Laboratory Education,” to save ASU’s program; the Society urged members to write the school’s leadership as well the chairs of the Arizona House and Senate committees on Education and Health. The response was overwhelming, generating over 4,000 letters in a 12-hour period.
ASCP has learned that a proposal has been presented to the school’s Board of Regents that would impose a $1,000 tuition increase to students, with the hope of offsetting with some industry donations. There has been no word if the Regents will regard the proposal as a viable option to maintain the program. In addition, ASCP President Barbara J. McKenna, MD, FASCP, recently sent a letter to the President of the University of South Alabama urging that the school’s program remain open and that the University investigate the availability of stimulus dollars.
ASCP is working with Western Carolina University, which will target the state’s governor to use some of the stimulus money provided North Carolina. The Society also recently reached out to the program directors at the University of Wisconsin to inform them of our desire to take action and develop strategies that could save their respective program.
Part II: Stimulus Money Available but Requires Cooperation and Community Work
MT/CLS schools at risk or programs seeking to expand should proactively seek money available in the stimulus package. Dollars are earmarked for health care professions training, and funds are available through community-based programs that address the training and retraining of the workforce.
The most important provisions for the laboratory education community are the Department of Labor’s Community-Based Job Training Grants (CBJTG) program. The stimulus bill provides $250 million through the CBJTG program that is prioritized for jobs in the health care sector. To implement these grants, local workforce investment boards are authorized to enter into contracts with institutions of higher education or other eligible training providers if the local board determines that it would facilitate the training of multiple individuals for high-demand occupations. Last year, a consortium of universities and colleges in Minnesota accessed a $2 million CBJTG grant to restore and build 2- and 4-year laboratory training programs throughout the state.
Part III: ASCP Legislative Strategy to Address Workforce Revised
Given the availability of money in the government’s stimulus package, ASCP has revised its legislative strategy to advocate for a robust appropriation for the CBJTG that would be in addition to the $250 million that will be available in the next few months.
In addition, $200 million in the stimulus will be divided between Title VII Allied Health Programs and Title VIII Nursing Programs at the Health Services and Resources Administration. ASCP is urging the US Department of Health and Human Services to designate a portion of the $200 million available for Health Professions Training in the stimulus package to medical laboratory science students and laboratory training programs. (Title VII Allied Health Programs).
ASCP will continue to keep readers informed about the status of these schools as well as any other possible closures that could impact the practice of laboratory medicine.
CMS Tasks MEDCAC Panel to Examine Genetic Testing Coverage
The Centers for Medicare & Medicaid Services (CMS) is considering the extent to which genetic tests should be covered under the Medicare program. CMS has asked the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC), the group that advises CMS on coverage issues, to develop recommendations regarding the desirable characteristics of evidence that could be used by the Medicare program to determine whether genetic testing as a laboratory diagnostic service improves health outcomes.
The first forum on this issue, which convened in late February, solicited input from both government researchers as well as industry on the types of data necessary and available for coverage decisions on genetic testing as a diagnostic tool. Specifically, MEDCAC is taking a closer look at how diagnostic genetic testing differs from diagnostic testing in general, how analytical validity is determined for genetic diagnostic tests, and how genetic testing affects outcomes for diagnostic, prognostic, and pharmacogenomic assessments in patient care. In addition, MEDCAC is interested in learning more about whether diagnostic genetic testing improves patient-centered outcomes, both directly and indirectly, and if the age of the Medicare beneficiary population presents unique challenges in the interpretation of genetic tests. MEDCAC’s next meeting, scheduled for early May, will examine the types of evidence that be needed to evaluate screening genetic tests for Medicare coverage. Throughout these discussions, the committee seeks to identify current data deficiencies on genetic testing that warrant additional research.
State News
Support for State Licensure Gains Momentum
ASCP is seeking support from its members in Minnesota to help pass state legislation to license laboratory personnel. Both the Minnesota House and Senate are working on legislation to license medical laboratory professionals, such as medical laboratory scientists, specialists, and technicians. The Senate bill was recently approved by the Senate Health Committee. Neither the House nor the Senate has passed its bill.
ASCP is pleased to report that the Minnesota licensure bills are the product of a consensus effort. The Minnesota Licensure Coalition has worked diligently to address the concerns of the various stakeholders in the pathology and laboratory medicine community.
ASCP has been a strong proponent of licensure as a means of assuring qualified, competent laboratorians. Such legislation in the state has been attempted previously, but efforts were always blocked. Supporters believe that circumstances are favorable in this legislative session and that a licensure bill may indeed pass the Minnesota legislature.
To view a copy of ASCP’s recent letter to the Chair of the House Health Care Committee’s Licensure Subcommittee, click here.
For the latest developments on licensure efforts in Minnesota, check future issues of E-Policy.
Georgia Direct Billing Legislation Garners Local, National Support
ASCP, the Georgia Association of Pathologists, and the College of American Pathologists recently joined forces to urge the Georgia Legislature to support HB 403, a bill that requires ordering physicians who neither perform nor supervise an anatomical pathology test to disclose to patients or third party payers the laboratory charge to the patient.
The bill under consideration by the Georgia Health and Life Subcommittee is aimed at protecting Georgia patients against unnecessary markup charges and providing transparency in billing. ASCP continues to be concerned that such practices occur, believing there to be the potential for adverse impact on patient care and the overall Georgia health care system, including distortions in medical decision-making, test over-utilization, and increased costs. Efforts to avert questionable billing practices and protect the well-being of patients continue to drive the Society’s advocacy work.
HB 403 specifically requires the referring physician to disclose via statement or bill the following: The name and address of the physician or laboratory that performed the service and the actual amount charged for the service. The bill also prohibits the ordering physician from charging the patient or third party payer over the charge disclosed in the correspondence.
ASCP has always maintained that there is an ethical imperative involved in questionable billing practices. HB 403 is consistent with ethics standards outlined by the American Medical Association, which states that “a physician should not charge a markup, commission, or profit on the services rendered by others...”
Twenty other states have already taken legislative action to preserve the standard of pathology and laboratory medicine and to protect their patients. These include AZ, CA, IA, LA, MD, MA, MT, NV, NJ, NY, RI, SC, TN, KS, OH, FL, MI, OR, UT, and WA.
ASCP will monitor the status of this legislation and report on in future editions of e-Policy.