ASCP, NSH Urge Anthem to Reconsider Reimbursement Cuts

On January 15, ASCP and the National Society for Histotechnology (NSH) met with representatives of Anthem Blue Cross Blue Shield to address concerns about reimbursement for pathology and laboratory services. ASCP and NSH leaders, including ASCP President-elect Kim Sanford, MD, MASCP, raised concern that a number of the reimbursement rates recently adopted by Anthem are exceptionally low and that some do not cover the cost of providing particular services.

ASCP and NSH representatives urged Anthem to reconsider its recent price cuts. Anthem indicated that it is attempting to realign the markets it serves so that its customers experience uniform costs, regardless of the site of service. ASCP and NSH responded that pathology and clinical laboratories are relatively unique in that there is significant variation in terms of the pathology and clinical laboratory services provided and that this can have a profound effect on each laboratory’s costs and the fees that must be charged to remain operational. ASCP and NSH leaders noted that Anthem’s fees are having a disproportionately negative impact on pathology practices, hospital laboratories, and rural laboratories where diagnostic costs tend to be higher than those found in large reference laboratories. These cuts are undermining access to care for pathology and laboratory services.

Other articles in the February 2020 ePolicy News:

• ASCP’s Advocacy Yields Key Changes in NGS Coverage Policy
• Virginia Legislature Working on Surprise Billing
• Gearing Up for the ASCLS Legislative Symposium
• ASCP, AMA Urge Changes to CMS 2020 MIPS Measure Removal/QCDR Policies
• Choosing Wisely Champions Deadline Extended
• ASCP Seeking Effective Test Utilization Recommendations

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.