May 2021—Since the $1.9 trillion American Rescue Plan was signed into law in March, pathologists have been both excited and confused about its ramifications for our community. I’ve heard from many of my colleagues who expect more money to flow to their labs, and that may not necessarily be the case. The lab I run has not seen this new funding directly.
Congress has made significant investments to support diagnostic testing in this bill and others enacted over the past year. The CAP is grateful for the support and recognizes that if we don’t receive funds directly, we will find funds flowing indirectly to our laboratories in one form or another. For example, Congress has ensured the necessary tests for COVID-19 that our laboratories run will be covered. This includes the tests for the uninsured.
The CAP was instrumental in achieving big wins for us in this bill —but there were also places where we didn’t win. I’d like to review some of the most important elements to help all CAP members understand what to expect for your laboratories.
The headline that most pathologists already know about is the funding for testing, tracing, and mitigation measures related to the COVID-19 pandemic. The Department of Health and Human Services received some $48 billion for this work, with specific instruction to implement a national testing, tracing, and surveillance strategy; to support states in their pandemic-fighting efforts; and to fund development, manufacturing, and distribution of diagnostic tests. One important clause in how the HHS should allocate this funding is that it should invest in laboratory capacity, including academic, research, and other labs that could be used to run COVID-19 tests.
Beyond that big news, the bill included several other important elements of interest to the pathology community. It set aside $1.75 billion to fund sequencing and surveillance efforts for SARS-CoV-2, adding much-needed funding to sequence genomes and identify new mutations. An allocation of $500 million was directed to the Centers for Disease Control and Prevention to modernize data surveillance and analytics for public health, including the development of an early-warning system for disease to track COVID-19 variants and emerging biological threats. Separately, $750 million went to the CDC for global health efforts.
Also allocated is $8.5 billion to pay back health care providers in rural areas for expenses and lost revenues associated with the pandemic (this is separate from the Provider Relief Fund established earlier). Additionally, $10 billion was set aside for activities related to the Defense Production Act, including the procurement of medical supplies and equipment, while $15 billion was directed to the distribution and administration of vaccines.
The CAP supported and directly lobbied for many of these funding allocations. We sent letters to leadership members in the U.S. House of Representatives and Senate urging them to fund the expansion of diagnostic tests for use in a broad range of settings, as well as sequencing and surveillance efforts and a robust national vaccination program. We strongly encouraged more relief funds for providers, particularly in rural settings. I am relieved and grateful that all of these priorities were included in the final bill. They offer substantial support for our community. They may not, however, directly lead to new funding for all laboratories. Like most community hospital labs, my lab does not sequence SARS-CoV-2 genomes; the $1.75 billion set aside for that work will bypass many pathology practices like mine.
There were also some measures the CAP pushed hard for that did not make it into the final bill. We asked for, but did not get, an increase in Medicare reimbursement rates for COVID-19 testing. We also requested hazard pay for all pathology staff members and support for medical examiners as part of a public health workforce. None of these items was included in the final legislation, but the CAP will continue to ensure that our voices are represented on these and other important issues to our elected officials in the future.
Let me close here with a few lines from the letter I sent on behalf of the CAP to Senate leaders on Feb. 19 as the bill was being debated.
“The current pandemic has brought to the forefront the vital role of pathologists and the value that they bring to medicine. . . . Pathologists and the services they provide, including ensuring laboratory quality in communities across the United States, are at the foundation of our health care system. We cannot allow this foundation to erode any further.”
It is truly an honor to represent the CAP and its entire membership, and I hope my words resonate with all of you.
Dr. Godbey welcomes communication from CAP members. Write to him at president@cap.org.