September 2007 Clinical Laboratory News: Washington Profiles

September 2007: Volume 33, Number 9

HHS Announces Nearly $900 Million for State Emergency Preparedness

HHS announced in July that the agency would be providing $896.7 million to certain states, territories, and four metropolitan areas to improve and sustain their ability to respond to public health emergencies. The CDC is coordinating the funding to be used for preparedness and response to public health emergencies including terrorism, and pandemic influenza.

The funding includes: $175 million to assist public health departments in their pandemic influenza planning efforts; $35 million to improve the early detection, surveillance, and investigative capabilities of poison control centers to provide information to health care providers and the public to respond to chemical, biological, radiological, and nuclear events; and $5.4 million for states bordering Mexico and Canada for the development and implementation of a program to provide effective detection, investigation, and reporting of urgent infectious disease cases in the three nations’ shared border regions.

This funding is in addition to the $430 million announced in June that will be used to strengthen the ability of hospitals and other health care facilities to respond to bioterror attacks, infectious diseases, and natural disasters that may cause mass casualties. Additional information is available on the HHS Web site.

Lab Groups Recommend Cross Walking New Codes in 2008

In July, the College of American Pathologists (CAP) and American Clinical Laboratory Association (ACLA) joined others from the clinical laboratory industry in Baltimore to present payment recommendations to CMS on new and revised CPT codes currently under consideration for inclusion in the 2008 Clinical Laboratory Fee Schedule. The groups recommend that the new codes be cross-walked—rather than gap-filled—to existing codes. The cross-walking method is used when a new test is similar to an existing code, multiple codes, or a portion of an existing test code. The gap-fill method is used when no comparable existing test is available, allowing CMS to set reimbursement rates for a year and then evaluate those rates to set national limitation amounts.

In addition to the cross-walk decisions, ACLA also voiced opposition to CMS’s proposed deletion of CPT codes 83036 and 83037 for glycosylated hemoglobin A1c testing. Officials have suggested creating a single G code for this testing category. “ACLA does not understand the need for a G-code and respectfully requests an explanation as to why CMS is proposing this,” said a statement from the organization.

The 2008 Clinical Lab Fee Schedule will be effective as of Jan. 1, 2008. CMS is expected to issue fees and instructions to Medicare carriers for implementation of the new schedule in late October. Additional information can be found at both the CAP Web site and the ACLA Web site.

Joint Commission Appoints New President

In July, The Joint Commission Board of Commissioners named Mark R. Chassin, MD, MPP, MPH, as President to succeed Dennis S. O’Leary, MD, who has led the accreditation organization for the past 21 years.

Chassin is currently a Professor of Health Policy and Chairman of the Department of Health Policy at Mount Sinai School of Medicine in New York, N.Y., as well as the Executive Vice President for Excellence in Patient Care at The Mount Sinai Medical Center. His research during his 12 years at Mount Sinai has focused on developing health care quality measures, using those measures in quality improvement, and understanding the relationship of quality measurement and improvement to health policy. He has served as the Commissioner of the New York State Department of Health, is a member of the Institute of Medicine of the National Academy of Sciences, and has co-chaired its National Roundtable on Health Care Quality.

Chassin’s appointment as President is effective January 1, 2008. More detailed information and a full biography are available on The Joint Commission’s Web site

CLSI Releases Newborn Screening Standard

The Clinical Laboratory Standards Institute (CLSI) recently published a new standard, Blood Collection on Filter Paper for Newborn Screening Programs; Approved Standard—Fifth Edition (LA4-A5). This new standard addresses issues associated with specimen collection, the filter paper collection device, and the transfer of blood onto filter paper, and provides uniform techniques for collecting the best possible specimen for use in newborn screening programs.

The goal of this standard is to improve and ensure the quality of blood spots collected from newborns. Issues addressed include procedures for applying blood collected by heelstick directly onto the preprinted circles of filter paper; recommendations on the source of blood; other techniques for collection of blood spot specimens; and specifications for the filter paper, handling, and the mailing package. This standard replaces the fourth edition approved standard, LA4-A4, which was published in 2003.


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