THERE’S A NEW CHALLENGE to the near-monopoly on cytology proficiency testing held by Midwest Institute of Medical Education(MIME) of Indianapolis, Indiana.
Last Friday, the College of American Pathologists (CAP) announced a new bill in the House of Representatives that would suspend and revise the existing federal program under which pathologists, cytotechnologists and other professionals involved in Pap testing must be evaluated. Under regulations announced during the past 18 months, during 2005, MIME is the only national provider of cytology proficiency testing (PT) and the State of Maryland’s cytology PT program can be used by residents of that state. CAP’s cytology PT program has federal approval for use in 2006.
Bill Has Three Co-Sponsors
The bill is H.R. 4268 and was introduced by Rep. Nathan Deal, a Republican from Georgia who chairs the house sub-committee with jurisdiction over this proficiency testing program. Other original co-sponsors are Reps. Sue Myrick, R-NC and Tom Price, R- CA. Titled “The Proficiency Testing Improvement Act of 2005,” the bill calls for a suspension of cytology PT testing for a one-year period.
The bill also does not allow cytology PT testing to resume until “the Secretary of Health and Human Services makes changes advocated by CAP and nearly 60 other national and state pathology societies.”
When the Centers for Medicare and Medicaid Services (CMS) announced, late in 2004, that cytology proficiency testing would be required in 2005 and that there would be only one nationwide provider of such PT testing, the outcry by the cytology profession was immediate and loud.
Criticisms Of The Program
Critics of the program note that, since the original rules governing cytology proficiency testing had been issued in 1992, advances in science, diagnostic technology, and medical knowledge have rendered these rules ineffective in meeting their objective of protecting patient health. They argue that, for these reasons alone, cytology PT testing should be deferred until updated and appropriate guidelines can be instituted.
Another firestorm of controversy was the decision by CMS, not only to authorize one national provider for the cytology PT program, but to select Midwest Institute of Medical Education as that sole source. This has caused many cytology professionals to question how and why CMS made these decisions, and whether undue influence played a role in CMS’s decision to authorize only one nationwide provider, and give that opportunity to MIME.