Congress
ASCP Unveils Health Care Reform Agenda
Urges Strong Prohibitions on Self Referral
ASCP recently unveiled its health care reform legislative agenda for 2009. ASCP developed this agenda to be proactive and to respond to a series of policy options released by Senator Baucus and the Senate Finance Committee as it initiated Congressional efforts to reform the nation’s health care system.
Figuring prominently in ASCP’s 2009 health care reform agenda are self referral/markups, Physician Quality Reporting Initiative, Sustainable Growth Rate, health information technology, physician and non-physician workforce development, and the proper valuation of medical services, among others. ASCP will use its 2009 health care reform agenda as a template for lobbying Congress on the multitude of policy options being considered by both the House of Representatives and the Senate.
ASCP commented that the Senate Finance Committee has not provided sufficient attention to the issue of physician self referral. While Senate Finance Committee white papers have addressed the issue of self referral in imaging and physician-owned hospitals, they have not addressed the issue as it relates to anatomic pathology. Preventing the overutilization of anatomic pathology services by ordering providers is one of ASCP’s top priorities. This issue was one of the key subjects on which ASCP members lobbied Congress at ASCP’s Annual Hill Day in March. ASCP is recommending that Congress exempt anatomic pathology from the Stark law’s in-office ancillary services exception.
In addition, ASCP also is recommending that:
- the Sustainable Growth Rate formula under Medicare be repealed;
- the Physician Quality Reporting Initiative be broadened to allow physicians participating in a voluntary maintenance of certification program to receive incentive payments;
- independent clinical laboratories be allowed to receive Electronic Health Records Meaningful Use Incentive Payments; and
- the government develop a new and more comprehensive workforce development strategy for physicians and non-physician laboratory professionals.
As Congress establishes mechanisms to focus on over-reimbursed physician and other health care services, ASCP has urged that Congress create a process that allows for the revaluation of those services that are currently under-reimbursed.
To obtain a copy of ASCP’s 2009 legislative advocacy agenda, click here.
ASCP Submits Testimony to House Ways & Means Committee on Health Reform
In anticipation of the powerful House Ways and Means Committee’s upcoming deliberations on health reform, ASCP has submitted testimony on a number of the issues affecting pathology and laboratory medicine and patient care. The Ways and Means Committee will soon conduct a hearing on Health Reform in the 21st Century: Proposals to Reform the Health System.
The hearing, framed around the House Tri-Committee Draft Proposal for Health Reform, will address many of the same issues as the Senate Finance Committee’s draft proposal for health reform. Similarly, ASCP raised concern that the House Tri-Committee proposal does not adequately consider the issue of self referral, particularly with regard to anatomic pathology services. ASCP also raised concern about PQRI, SGR, Electronic Health Records, co-pays on clinical laboratory fee schedule Medicare Part B payments, and workforce development, among others.
Federal
CDC Releases Recommendations for Molecular Genetic Testing Best Practices
Last month, the Centers for Disease Control and Prevention (CDC) released Good Laboratory Practices for Molecular Genetic Testing for Heritable Diseases and Conditions. The report appeared in the June 12, 2009 issue of the Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports (Volume 58, Number RR-6).
The recommendations were developed by the Clinical Laboratory Improvement Advisory Committee (CLIAC) and were based on both national and international molecular genetic testing quality standards and guidelines. The recommended practices address the total testing process (including the preanalytic, analytic, and postanalytic phases), laboratory responsibilities regarding authorized persons, confidentiality of patient information, personnel competency, considerations before introducing molecular genetic testing or offering new molecular genetic tests, and the quality management system approach to molecular genetic testing.
The recommendations were developed for laboratories that perform molecular genetic testing for heritable diseases and conditions, and for medical and public health professionals who evaluate laboratory practices and policies to improve the quality of molecular genetic laboratory services. The report also serves as a resource for consumers of laboratory services to better inform their use of molecular genetic tests and test results in health assessment and care.
CMS Proposed PFS Rule Fails to Address Markups of Anatomic Pathology Services
On July 2, the Centers for Medicare and Medicaid Services (CMS) released its proposed Physician Fee Schedule (PFS) rule for 2010. In so doing, the agency failed to revise the anti-markup rule on diagnostic services. ASCP is in the process of studying the proposed PFS rule. The rule contains several proposals that may affect pathology and laboratory medicine. CMS is proposing to modify the self referral requirements for the “stand-in–the-shoes” issue for physicians with a direct or indirect compensation arrangement with an entity furnishing designated health services. The rule also amends the requirements for when a physician signature is required for services covered by the Clinical Laboratory Fee Schedule.
ASCP hoped that CMS would fix several flaws it created as part of last year’s physician fee schedule (PFS) rule that unintentionally undermined the agency’s anti-markup rule on diagnostic services. CMS erred in last year’s revision of the rule by deleting the purchased test rules, thinking it was unnecessary, and restructuring the anti-markup rule in such a way that exempts those diagnostic services that do not require physician supervision and oversight. Neither the Clinical Laboratory Improvement Amendments of 1988 (CLIA) nor the Medicare rules require physician supervision of the technical component of anatomic pathology services. Oddly, the very services that prompted CMS’s attempts to clamp down on markups of anatomic pathology services by ordering physicians appear exempt from the revised rules. ASCP met earlier this year with CMS regarding the issue, though CMS officials voiced concern that due to new leadership at the agency it may need to study the issue further before changing the current requirements.
State News
ASCP Continues Advocacy Efforts to Avoid CLS School Closure
Latest Campaign Aims to Save University of South Alabama Program
ASCP continues its efforts to assist Clinical Laboratory Science programs threatened with closure. Most recently the Society has launched an advocacy campaign aimed at staving off plans to close the program at the University of South Alabama. ASCP members have written to Alabama Governor Robert Riley, urging him to explore the use of state stimulus money to save the program, since monies are allocated in the stimulus package for the training of health care professionals. Proponents of saving the school’s program assert that spending the money to maintain the CLS program is appropriate.
The University has a strong tradition of supplying the state with qualified laboratory personnel. For example, the program supplies an average of 30% of the CLS/MT staff at eight area hospitals. Moreover, the Society has sent a direct appeal to Governor Riley in the form of a letter from ASCP President Barbara J. McKenna, MD, FASCP. “ASCP urges you to be the catalyst to save a program that not only serves your community but also serves patients nationwide and throughout the world,” Dr. McKenna wrote. “The need for skilled, qualified personnel in the laboratory is the key to proper diagnosis and treatment.” ASCP has participated in a number of campaigns to save CLS/MT programs nationwide. Such participation demonstrates the importance of the profession and the urgent need to replenish the supply of qualified laboratory professionals. Urge Governor Riley to Take Action.
Society News
ASCP Launches Public Policy Internship Program
The American Society for Clinical Pathology is seeking a public policy intern to assist with advocacy, research, lobbying and writing. Interns will work on a variety of laboratory and health policy issues in ASCP’s Washington, D.C. Office. The program is a great opportunity for individuals interested in health policy, public health, and politics.
The ASCP internship program is suitable for undergraduate, graduate and post-graduate individuals. Participants will receive a stipend. Applications for interns will be accepted on an ongoing basis; the duration of the internship shall be mutually agreed upon between ASCP and the intern. Individuals interested in applying for the program may submit a cover letter, resume and writing samples to Ms. Shaun Hill by e-mail at shaun.hill@ascp.org. For further details, contact Ms. Hill at 202.347.4450.