ePolicy News September/October 2017

Oct 02, 2017
Read the latest ASCP policy news from Washington, DC.

ASCP Continues Push for Better CMS Medicare Policies

August and September were busy months in Washington, DC, for ASCP, as the Society was actively urging the Centers for Medicare and Medicaid Services to make substantive changes to several regulations that impact pathology and laboratory medicine.

On Aug. 21, ASCP submitted comments on Medicare’s Quality Payment Program (QPP) Proposed Rule for calendar year 2018. In that rule, pathologists scored a victory when CMS adopted an ASCP proposal to recognize CME as a measure in the QPP’s Improvement Activities (IA) domain. The proposal should make it much easier for pathologists to satisfy the Merit-based Incentive Payment System (MIPS) IA domain requirements. ASCP continues to advocate for a) more meaningful participation in pay-for-performance schemes for pathologists; b) increased flexibility for non-patient facing providers such as pathologists; and c) decreased reporting burden allowing providers to focus on patient care.

In addition, ASCP submitted two comment letters on the Medicare Physician Fee Schedule Proposed Rule. The first letter raised concerns about the Agency’s plans to reprice the Clinical Laboratory Fee Schedule, per the Protecting Access to Medicare Act. ASCP opposes CMS’ exclusion of hospital and physician office laboratory data, which typically are paid higher payment rates, from the calculation of a median payment rates. In separate comments, ASCP opposed a number of CMS’ proposals to reduce the payment amounts for such services as Pathology Consultation during Surgery (CPT Codes 88333 and 88334); Tumor Immunohistochemistry (CPT Codes 88360 and 88361); Therapeutic Apheresis Codes (CPT codes 36511, 36512, 36513, 36514, 36516, and 36522); Diagnostic Bone Marrow Aspiration and Biopsy Services (CPT Codes 2093X, 38220, 38221, and 382X3). ASCP also urged CMS to finalize a proposal in the Medicare Outpatient Prospective Payment System Proposed Rule to change the Date of Service (14-day rule) Policy. CMS finally proposed reversing its current policy that hospitals must bill for laboratory tests performed by independent labs on outpatients within 14 days of discharge. In developing our comments, ASCP worked closely with members of the pathology and laboratory community, including the College of American Pathologists and the American Clinical Laboratory Association.

USPSTF Proposes to Reverse its Recommendations on Cervical Co-Testing

On Sept. 12, 2017, the United States Preventive Services Task Force (USPSTF) proposed to change its recommendations for screening women for cervical cancer. In it, USPSTF proposed woman be screened “every 3 years with cervical cytology alone or every five years with high-risk human papillomavirus (hrHPV) testing alone in women ages 30-65.” This departs from the Task Force’s current recommendation, which urges co-testing with cervical cytology and HPV testing every 5 years for women ages 30-65. The current USPSTF requirement is based, in part, on a guideline developed by ASCP, along with the American Cancer Society (ACS) and the American Society for Colposcopy and Cervical Pathology (ASCCP). This guideline, published in March 2012, outlines recommended screening protocols for the prevention and early detection of cervical cancer. These guidelines recommend co-testing every 5 years for women ages 30 to 65. While ASCP is currently reviewing the USPSTF draft recommendation, we continue to support the ACS/ASCCP/ASCP guidelines.   ASCP intends to submit formal comments on the proposal and encourages its members interested in submitting comments on the proposal to do so before the October 9th deadline.

ASCP Announces 2017 Choosing Wisely Champions

ASCP announced its 2017 Choosing Wisely Champions during a special session at the ASCP 2017 Annual Meeting, Sept. 6-8, in Chicago. ASCP’s Choosing Wisely Champions program recognizes healthcare leaders for their commitment to the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely Campaign. The campaign’s ideals are intended to reduce test overuse and to encourage clinicians and patients to question which tests are really necessary to reduce test overuse and improve the nation’s healthcare system.

The 2017 Choosing Wisely Champions are listed below:

Henry Ford Health System
Jack Jordan, MA*
Director of Performance Excellence and Quality

Vanderbilt University Medical Center
Meghan Kapp, MD*
Clinical fellow in Renal Pathology

University of California, Davis
Christopher Polage, MD*
Assistant Professor of Clinical Pathology; Director of the Clinical Microbiology Laboratory UC-Davis Medical Center

University of Washington & Harborview Medical Center
Geoffrey Baird, MD, PhD, FASCP
Residency Program Director; Interim Chair of Department of Laboratory Medicine; Director of Clinical Chemistry-Harborview Medical Center

Children’s Hospital of Atlanta
Silvia Bunting, MD

University of Mississippi Medical Center
Lana Jackson, MD
Associate Professor of Otolaryngology

University of Texas Medical Branch, Hematology Department
Mayukh Sarkar, PhD, MLS (ASCP)CM
Medical Laboratory Scientist

University of Oklahoma Health Sciences Center
Yaolin Zhou, MD
Associate Professor; Director of Molecular Pathology

This is ASCP’s second year participating in the Choosing Wisely Champions program in collaboration with the ABIM Foundation. During the special session at ASCP 2017, entitled “Choosing Wisely Champions Bring Collaboration to Center Stage: Influencing Practices and Demonstrating Outcomes,” Mr. Jordan, Dr. Kapp, and Dr. Polage gave presentations highlighting patient and organizational outcomes, as well as the collaborative effort of healthcare teams to bring about the practice changes that improved utilization. These Champions were the top three chosen by the ASCP Effective Test Utilization Steering Committee based on their Choosing Wisely activities and were selected to present at ASCP 2017.

Highlights from the 2017 ASCP Annual Meeting NPQR Session

ASCP’s National Pathology Quality Registry (NPQR) is a quality improvement and benchmarking program that ASCP established in 2016. The registry aims to improve patient outcomes by helping laboratories assess and optimize their quality and performance in key ways:

• Monitoring appropriate utilization of laboratory testing
• Improving pre-analytical processes
• Optimizing turnaround time and critical value reporting
• Establishing best practices through national and peer group comparisons
• Assessing analytical and diagnostic accuracy

Additionally, ASCP members and others who participate will be able to use NPQR to satisfy quality reporting requirements from the Centers for Medicare and Medicaid Services’ (CMS) Quality Payment Program under the Merit-based Incentive Payment System (MIPS).

ASCP 2017 attendees were able to preview the NPQR at the Annual Meeting. The registry will feature interactive dashboards and reports that aim to drive change in processes, utilization, and ultimately patient care.

For more information regarding ASCP's advocacy initiatives and policy positions, please contact ASCP's Center for Public Policy at (202-347-4450).


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