Due in large part to advocacy efforts on the part of the California Medical Association (CMA), Aetna has announced they will be eliminating their dual certification requirement for Dermatologists and Dermatopathologists, meaning payment of surgical pathology services will continue without additional certification.
The announcement comes roughly one month after Aetna notified physicians that, effective August 1, 2012, practices performing in-office pathology testing will be required to be both Clinical Laboratory Improvement Amendments (CLIA) certified and accredited with the College of American Pathologists (CAP) in order to be paid.
Finding the changes to be overly burdensome to physicians, CMA raised concerns over the dual certification requirement, and requested that Aetna explain the need for such a practice.
CMA’s comments noted that although the Centers for Medicare & Medicaid Services (CMS) may recognize CAP as an approved accreditation organization, CMS does not require both a CLIA certification and a specialty society accreditation to perform in-office pathology testing services.
Further, CMA expressed concerns with the ability of physicians to obtain the CAP accreditation prior to the deadline imposed by Aetna. According to CAP, the accreditation process takes approximately 90 days. Additionally, the association noted that the process of obtaining a secondary accreditation can be very costly for practices.
The announcement that Aetna will be eliminating the requirement for Dermatologists and Dermatopathologists is welcome news; however, CMA is still waiting to obtain clarification on whether Aetna will require dual certification for other specialists performing surgical pathology services in their office.
Practices with questions about the letter can contact Tammy Gaul, senior network manager at Aetna, at (215) 775-6604.
Contact: CMA reimbursement help line, (888) 401-5911 or firstname.lastname@example.org.