CAP Applauds House Committee Efforts to Stop Medicare Cuts and Stabilize Pathology and Laboratory Payments
The College of American Pathologists (CAP) commends the House Energy and Commerce Committee for holding hearings this week on the Saving Access to Laboratory Services Act legislation to extend incentive payments for participation in eligible alternative payment models, Provider Reimbursement Stability Act of 2023, and the Improving Seniors Timely Access to Care Act of 2023. The CAP urges Congress to take up and pass these bills to improve patient care, stabilize physician payments, and reduce burdens on pathologists and laboratories.
“These important pieces of legislation will not only reduce undue burdens on pathologists and cut down on administrative obstacles to the timely diagnoses that patients deserve, they will help stabilize the physician payment system and provide much needed stability for medical laboratories and the patients they serve,” said CAP President Donald S. Karcher, MD, FCAP. “It is imperative, for patients and physicians, that Congress provide much needed relief in the form of crucial financial stability, reducing reporting burdens, and shortening prior authorization decisions for the future of health care in our nation. As the Committee continues to discuss and develop policies to reform the physician fee schedule and improve patient outcomes, the CAP asks that the Committee pass legislation to mitigate the impact of the impending Medicare cuts for 2024, and beyond, until long-term relief is enacted into law.”
The following legislation will have a significant impact on improving the health of communities across the country:
The Saving Access to Laboratory Services Act, or SALSA, is a permanent solution that would set Medicare reimbursement for clinical laboratory services on a sustainable path forward. SALSA would give the Centers for Medicare & Medicaid Services (CMS) new authority to collect private market data through statistically valid sampling from all laboratory segments for the widely available test services where previous data collection was inadequate. The bill also ensures true private market rates are included and provides a much-needed reduction in the reporting burden. The CAP is encouraging Congress to pass this legislation that will protect clinical laboratories, the Medicare program, and patients from the impact of dramatic rate increases or decreases.
Amending title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models (APMs) gives added incentive payments to provide high-quality and cost-efficient care. The CAP is asking Congress to extend the Advanced APM Incentive Payment and increase it to 5% in 2024.
Provider Reimbursement Stability Act of 2023 increases the budget neutrality threshold in Medicare, provides updates to the direct practice expense input used by the CMS, and provides for limitations in the variance of the conversion factor from year to year, to prevent onerous and burdensome Medicare cuts. Budget neutrality has been considered an important component of controlling costs. However, it pits physicians against one another and imposes barriers to high-quality, high-value care.
Improving Seniors Timely Access to Care Act of 2023 addresses excessive wait times for prior authorization decisions. The current timeframe requirements generally include 72 hours for expedited (urgent) prior authorization decisions, and 14 calendar days for “standard” decisions. Delays associated with prior authorization have dire consequences for patients, ranging from negative effects on clinical outcomes to treatment abandonment.