ASCP Urges Anthem to Reconsider Cuts to Pathology, Laboratory Rates

Publication Date: Aug 2, 2019

On July 31, ASCP urged Anthem Blue Cross and Blue Shield to rescind its planned cuts in pathology and laboratory reimbursement rates. In a letter to Anthem’s President and Chief Executive Officer Gail K. Boudreaux, ASCP wrote that Anthem’s recently announced rates for many high-volume pathology and clinical laboratory services are exceedingly low in comparison to Medicare’s payment amounts.

Indeed, in a number of instances the new rates are even lower than state Medicaid rates. ASCP noted that in Missouri, Anthem plans to reduce payment for CPT 88305-26 (Level IV - Surgical pathology, gross and microscopic examination) from $66 to $14.43, a cut of almost 80 percent. Medicare’s rate of $39.64 is almost triple Anthem’s new Missouri rate while the state’s Medicaid rate of $31.35 is more than double the Anthem rate.

ASCP noted its concern the planned rates could have on the state of pathology and laboratory medicine and on patient access. For a copy of ASCP’s letter, click here.

Other articles in ePolicy News August 2019

CMS (Finally) Releases 2020 CY Physician Fee Schedule
ACLA Scores Major Legal Win in PAMA Lawsuit
Cervical Cancer Risk Guidelines Public Comment Now Open
NASEM Committee to Identify Gaps in Clinical Practice Guidelines for Acute Pain Opioid Prescriptions

To read more articles from ePolicy News click here.

For more information regarding ASCP's advocacy initiatives and policy positions, please contact ASCP's Center for Public Policy at (202) 408-1110.

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ASCP ePolicy News is supported by an unrestricted grant from Hologic.

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