CSP 74th Annual Meeting!

The CSP 74th Annual Meeting will be held in-person November 30 - December 4, 2021 at the Hyatt Regency San Francisco. Registration opens very soon! Watch for the Registration Announcement, mark your calendars and plan to join us for top-notch education and networking. We look forward to reconnecting with you in San Francisco!

Bill Advances on Eliminating Prior Auth for Biomarkers

SB 535 (Limon) would eliminate the ability of health plans or insurers to impose Prior Authorization requirements for either, (1) biomarker testing for an enrollee with advanced or metastatic stage 3 or 4 cancer, or (2) biomarker testing for cancer progression or reoccurrence in a patient with advanced or metastatic stage 3 or 4 cancer. It has the following definition: (c) For purposes of this section, “biomarker test” means a diagnostic test, such as single or multigene, of the cancer patient’s biospecimen, such as tissue, blood, or other bodily fluids, for DNA or RNA alterations, including phenotypic characteristics of a malignancy, to identify an individual with a subtype of cancer, in order to guide patient treatment   The CSP supports SB 535 which has passed the Senate and is awaiting approval in the Assembly Appropriations Committee. The bill would take effect on July 1, 2022 and was amended to also apply to Medi-Cal recipients.

Two Bills Moving in the Legislature to Expand Lab Testing for Pharmacists

The CSP has been seeking amendments to two bills, AB 1328 and SB 409, that would allow pharmacists to perform various types of waived tests. Currently pharmacists can perform and interpret tests that are used in the course of therapeutic drug monitoring in conjunction with a physician. They can also do tests related to common health care condition such as glucose and cholesterol. AB 1328 would allow them to perform any waived tests so long as they are CLIA compliant and have registered with LFS. There are some exceptions for tests related to surgery, diagnosis or treatment of heart failure, female fertility or ovulation. Efforts to expand the list of restricted tests to include liver/ kidney function have been resisted. Beyond the types of tests, the CSP is concerned with the ability to collect vaginal swabs, semen samples and performing any tests using venipuncture. We are joined in opposition with the CMA and other physician specialty organizations. Based upon recent amendments we view SB 409 as the best alternative but both bills are moving and would likely reach the Governor’s desk. We will update you on the outcome as the Legislature adjourns in early September.

State Budget Contains Some Relief on Medi-Cal Lab Rates

There is budget trailer bill language to resolve some longstanding issues with Medi-Cal lab rates using a benchmark of 80% of Medicare or the average rate paid by private payers, whichever is less. Two prior bills had passed the Legislature only to be vetoed by the Governor. In the meantime, labs and pathology groups had been subject to retroactive recoupments for prior claims paid because DHCS staff was not able to timely update the changing rates. While the trailer bill is not yet signed, it will eliminate the retroactive recoupment of claims paid in 2020-21, increase the Medicare methodology from 80 to 100% of Medicare in 2022 while still retaining the “lesser of” the average private pay rate, and also retain the current 10% cut that still applies to most Medi-Cal services. The CSP will provide more information once the budget bill is signed, and the actual rates are set.

CAP Elections

The CSP Board is proud to endorse two candidates for CAP President-Elect. Both candidates are CSP members and have met previously with the Board: Dr. Donald Karcher Dr. Tim Allen Ballots will be available to CAP members to vote electronically.