CAP prioritizes pathologists' needs in 2025

Liz Carey Feature Writer Smg 2023 Headshot
Washington Dc Capitol (2)

In a letter to the Trump administration and 119th Congress, the College of American Pathologists (CAP) prioritized the top regulatory, payer, and workforce issues facing anatomic pathologists and their laboratory teams in 2025.

The CAP has asked that President Donald Trump's incoming health policymakers work with the CAP on the following priorities:

Rescind the FDA's final rule on LDTs

Most recently, the CAP supported proposed legislation, the Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2023, which would create a three-tiered risk-based system, expressly authorizing the FDA to fully regulate the highest-risk laboratory developed tests (LDTs) while leveraging existing structures to improve and promote patient safety with all other LDTs, the CAP's letter dated January 21 stated. The organization representing physicians noted that it has opposed proposals that would vest the U.S. Centers for Medicare and Medicaid Services (CMS) with exclusive jurisdiction over LDTs.

Stabilize the Medicare payment system and mitigate cuts that threaten lab operations

The CAP has asked for an inflationary update to the Medicare Physician Fee Schedule (MPFS), among other measures that include preserving current procedural terminology and relative value update committee processes. The committee describes the resources required to provide physician services, according to the CAP.

Address critical workforce shortages by expanding physician training programs and federally supported training slots for pathologists

The CMS has not done enough to address the issue of the physician shortage, the CAP said. With the view that psychiatry and its subspecialties will receive at least half of Medicare-funded residency positions, the CAP is concerned that specialties such as pathology are experiencing significant workforce shortages that need to be addressed, especially in rural areas.

Promote fair insurance practices

Insurers are increasingly relying on inadequate networks of contracted physicians, the CAP noted, recommending the implementation of network adequacy requirements, prohibitions on the use of tiered and narrow physician networks, a restriction on anticompetitive "exclusive" or "preferred" contracts, as well as strengthening the enforcement of requirements that manage insurer interference and that support physician-led healthcare teams.

Streamline billing dispute processes and implement 'good faith estimate' requirements to protect uninsured and self-paying patients while ensuring fair physician reimbursement

"The Trump administration has an opportunity to finalize regulations that will implement new disclosure requirements, centralize the open negotiations process, increase flexibility around batching, and promote equitable access to independent dispute resolution for low-dollar disputes," the CAP stated. GFE requirements continue to be problematic for providers and could be misused by insurers, CAP said.

Support innovation and patient safety in laboratory AI applications while maintaining the leadership role of pathologists in clinical decision-making

The expansion of pathologists' responsibilities to include artificial intelligence (AI) will constitute an important new element in pathologists' role as CLIA lab directors and section directors. The CAP urged the Trump administration to recognize the leadership role that pathologists must have in the selection, configuration, deployment, application, and monitoring of AI systems involved in the preanalytical, analytical, and postanalytical phases of laboratory workflow.

Read the CAP's complete letter.

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