Recognition of Board-Certified Clinical Laboratory Professionals as Qualified Healthcare Professionals

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American College of Medical Genetics and Genomics

Aug 29, 2019, 10:00 ET

BETHESDA, Md., Aug. 29, 2019 /PRNewswire/ -- As laboratory testing increases in complexity, doctoral level (PhD, MD and DO) diagnostic laboratory professionals, such as clinical laboratory geneticists, are expected to provide complex laboratory interpretation in the context of a patient's medical history, family history and other test results. Clinical genetic diagnostic laboratories provide detailed reports to ordering physicians that contain an individualized clinical interpretation of results including clinical implications, significance of the findings and, when applicable, recommendations for follow-up testing and genetic counseling. The American College of Medical Genetics and Genomics (ACMG) strongly recommends that appropriately trained and board-certified doctoral level clinical laboratory professionals be recognized as Qualified Healthcare Professionals (QHPs) for the purpose of Medicare billing for certain services under the physician fee schedule.

What is prompting this strong recommendation at this time? While the technical components of genetic and genomic testing are covered under the clinical laboratory fee schedule (CLFS), clinical test interpretation for most of these tests is covered under the physician fee schedule (PFS). Under the PFS, only QHPs can directly bill Medicare. However, board-certified doctoral level laboratory professionals (including PhDs and MD or DO trained individuals not licensed to practice medicine in the US) currently do not qualify as QHPs and thus cannot bill Medicare directly for interpretive services. For doctoral-level clinical laboratory professionals to be recognized as QHPs, legislation is needed. Numerous other types of non-physician clinical professionals have already successfully achieved recognition as QHPs (e.g., clinical psychologists, physical therapists, physician assistants), and legislative initiatives for many others are currently underway.

In ACMG's just released recommendations, "Recognition of Board-Certified Clinical Laboratory Professionals as Qualified Healthcare Professionals," the ACMG recommends that appropriately trained and board-certified doctoral level diagnostic laboratory professionals be recognized by Medicare as QHPs for the purpose of individualized clinical interpretation of laboratory findings provided that 1) they possess a doctoral degree in a relevant life sciences discipline; 2) their training and certification include certain key components designed to support such individualized clinical interpretation; and 3) they review and combine analytical results, clinical findings, other laboratory results and family history when appropriate to issue interpretive reports in a high complexity CLIA-certified laboratory.

The new ACMG recommendation also details the key components of what the training and board certification must include.

ACMG President Anthony R. Gregg, MD, MBA, FACOG, FACMG said, "Genetic testing impacts patient care by informing diagnoses, surveillance strategies and therapies. These tests are routine in medicine today. At the core of any laboratory test is accurate communication with ordering clinicians. Genetic tests are unique because results are not simply "normal" or "abnormal". Board-certified laboratory geneticists provide test interpretation that prevents patient harm, and this alone saves health care dollars. It is the right time for the American College of Medical Genetics and Genomics (ACMG) to state loudly, our board-certified PhD laboratory geneticists are qualified healthcare professionals. ACMG is the professional organization of more than 600 board-certified laboratory geneticists, representing the majority of such professionals in the United States. The precise impact of these healthcare professionals is unknown, but anyone practicing clinical medicine knows it is large and important."

The full "Recognition of Board-Certified Clinical Laboratory Professionals as Qualified Healthcare Professionals" statement is available at https://www.acmg.net/PDFLibrary/PhDs_QHPs_Approved_Final_WebPosting08272019.pdf.

About the American College of Medical Genetics and Genomics (ACMG) and ACMG Foundation

Founded in 1991, the American College of Medical Genetics and Genomics (ACMG) is the only nationally recognized medical society dedicated to improving health through the clinical practice of medical genetics and genomics. The ACMG provides education, resources and a voice for more than 2,300 biochemical, clinical, cytogenetic, medical and molecular geneticists, genetic counselors and other healthcare professionals, nearly 80% of whom are board certified in the medical genetics specialties. The College's mission is to develop and sustain medical genetics-related initiatives in clinical and laboratory practice, education and advocacy. Four overarching strategies guide ACMG's work: 1) reinforce and expand ACMG's position as the leader and prominent authority in the field of medical genetics and genomics, including clinical research, while educating the medical community on the significant role that genetics and genomics will continue to play in understanding, preventing, treating and curing disease; 2) to secure and expand the professional workforce for medical genetics and genomics; 3) to advocate for the specialty; and 4) to provide best-in-class education to members and nonmembers. Genetics in Medicine, published monthly, is the official ACMG peer-reviewed journal. ACMG's website (www.acmg.net) offers resources including policy statements, practice guidelines, educational programs and a 'Find a Genetic Service' tool. The educational and public health programs of the ACMG are dependent upon charitable gifts from corporations, foundations and individuals through the ACMG Foundation for Genetic and Genomic Medicine.

Kathy Moran, MBA
[email protected]

SOURCE American College of Medical Genetics and Genomics