From the President’s Desk: Painful cuts ahead

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September 2020—Pathologists have been feeling the pain for months. The COVID-19 pandemic triggered furloughs and layoffs even as we ran a grueling race to implement and scale high-quality testing. And now looming cuts to pathologist physician payments threaten to make our situation even worse.

The Centers for Medicare and Medicaid Services in early August announced a proposed nine percent cut to payments for pathology services. This is the result of a budget neutrality requirement that was built into the relative value system decades ago. Intended to keep health care costs in check, this requirement has effectively turned Medicare reimbursements into a zero-sum game. If one group earns more, another has to earn less.

Dr. Godbey

Last year, the CMS decided that certain groups of physicians, such as primary care doctors, deserve higher pay for their services. While the CAP takes no issue with that increase, we strongly object to its consequences: that other groups, including pathologists, must take a significant reduction in payments to make up the difference. Effectively, anyone who does not generally bill evaluation and management (E/M) codes will see reductions in payment.

Though we didn’t know until this summer how deep the cuts to our services would be, the CAP’s advocacy group has been actively working on this issue since last year’s announcement that other physicians would see higher payments for their E/M services. The CMS alone cannot eliminate the budget neutrality requirement. That is why CAP experts are focused on working with legislators, your legislators, to waive the budget neutrality requirements that are at the root of the problem.