Surprise billing bills in limbo | USPSTF tempers urine test guidance | Blood cultures come first in sepsis

Dear LabPulse Member,

ORLANDO, FL - The College of American Pathologists (CAP) annual meeting at the sprawling and beautiful Gaylord Palms Resort and Convention Center near Orlando is in full swing.

CAP ended yesterday's sessions with a town hall on advocacy for members. The organization's top policy issue is influencing the range of federal legislative efforts on the table for surprise medical bills to ensure that patients aren't held responsible for unexpected out-of-network expenses, that networks are sufficiently inclusive of pathology specialists, and that a fair system for arbitration between pathologists and insurers is in place. I attended a panel on surprise billing and heard why it's unclear whether there is the time or will to get a bill passed this year.

Also at the meeting, which runs September 21-25, Dr. Patrick Godbey stepped up to the plate as CAP president. Dr. Godbey is the CEO and laboratory director of Southeastern Pathology Assoc. and laboratory director of Southeast Georgia Regional Medical Center, both of which are based in Brunswick, GA. He was honored during a Kentucky Derby-themed live music and dance party where pathologists donned fancy cocktail hats, ate grits and biscuits with gravy, and enjoyed mint juleps on the rocks.

Look out for additional coverage of CAP 2019 on LabPulse.com, including an interview with Dr. Godbey.

In other news, we covered the release today of updated guidance from the U.S. Preventive Services Task Force (USPSTF) on urine testing for bacteria in asymptomatic adults. As with the last update on this topic, the USPSTF is in favor of screening for asymptomatic bacteriuria in pregnant women with urine culture and against screening nonpregnant adults. The task force, however, downgraded its recommendation for screening pregnant women from grade A to grade B, explaining that the benefit of testing is more modest than previously believed. The group also cited the negative effects of antibiotic treatment.

Antibiotic stewardship is a big concern generally in healthcare systems. In a study published in the Annals of Internal Medicine, researchers stressed the importance of taking blood cultures in patients with sepsis prior to starting antibiotic therapy. Sensitivity was markedly reduced if antibiotic therapy was started immediately, making it hard to identify pathogens. The data may just make clinicians think twice about blind prescribing and the use of broad-spectrum antibiotics when sepsis is suspected, even though immediate treatment can be lifesaving.

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