Advocacy News

• CAP urges State Department to address physician visa delays
• Virginia enacts state law on lab steering
• Don't miss: CMS CLFS webinar April 16
• NIH indirect cost cap blocked as administration declines appeal
• President proposes HHS cuts in 2027 budget
• Coalition urges Congress to boost CDC genomic surveillance funding

The College of American Pathologists (CAP) and more than 20 national medical organizations are urging action on visa and immigration processing delays affecting international medical graduates, including physicians in training and practice across the U.S. health care system.

Zoom in: In an April 8 letter to the U.S. Departments of State and Homeland Security, the groups call for faster, more predictable physician visa and immigration processing, including a medical national interest exemption for physicians and trainees.

• The letter calls for the creation of a medical national interest exemption for physicians and trainees.
• It urges expedited processing of physician visa and immigration applications.
• It requests clearer guidance prioritizing physician and trainee cases.
• It seeks improved transparency on case status and processing timelines.

The impact: Visa delays and administrative holds are disrupting residency programs, limiting access to care in underserved communities, and removing trained physicians from the US health care system.

• The CAP is also advocating for a waiver of the $100,000 fee for H1B visas.

Virginia has set a national precedent on health plan lab referrals that will protect patients from the abusive health plan business practice of in-network pathology/laboratory steering. The CAP has asserted that such business practices by health plans harm patient care by undermining optimal, timely provision of pathology/laboratory services. 

On April 6, Virginia Governor Abigail Spanberger signed SB 745, supported by the CAP and the Virginia Society for Pathology (VSP).

The impact: The law prohibits health plans from steering referrals of pathology and lab services to an exclusive set of designated in-network laboratories, which is done by denying referrals to other in-network providers. 

• Under the Practitioner Self-Referral Act, health plans can’t restrict in-network referrals to only a few (or one) in-network laboratory or pathology providers, thereby excluding other in-network providers, with limited exceptions.
• The law, which does not apply to state-regulated HMOs, takes effect July 1. 

The backstory: The law targets insurer practices that directed patients and specimens to one or two designated commercial labs, sometimes out of state. 

• Physicians raised concerns about delayed diagnoses, fragmented care, and reduced access to in-network specialized pathology services.
• The CAP and VSP raised concerns with Virginia oversight agencies in 2025, including worries regarding impacts on Medicaid patients.
• In 2025, the CAP helped secure new AMA policies (H180.941) and (D180.975) reflecting the broad consensus in medicine that these practices are antithetical to optimal patient care.

What we're saying: In a March 2 letter urging enactment, CAP President Qihui "Jim" Zhai, MD, FCAP, wrote: 

"…This business practice of funneling pathology/laboratory referrals undermines the optimal practice of medicine and can harm Virginia patients without their knowledge."

Go deeper: Read support letters to Gov. Spanberger from the Medical Society of Virginia, the Virginia Hospital and Healthcare Association, and VSP.

CMS is hosting a webinar for labs that may need to report data under the Clinical Lab Fee Schedule (CLFS), with reporting beginning May 1.

The details: The 60-minute session is scheduled for April 16 at 3:00 PM ET. It will provide:

• An overview of applicable laboratory criteria and required data
• Guidance on user roles and CLFS Module registration
• Preparation resources and how to access them
• A brief demonstration of the CLFS Module

The impact: If your lab may be subject to CLFS reporting, this is an opportunity to understand requirements and prepare ahead of the May 1 start date.

What’s next: CMS will host a live Q&A following the presentation and encourages attendees to submit questions in advance.

Register

The Trump administration will not appeal a court ruling that blocks the 2025 proposed policy to cap National Institutes of Health (NIH) indirect cost rates at 15%.
Impact: The decision preserves current NIH funding structures, avoiding cuts included in the NIH policy that raised concerns for pathologists and the broader research community.

What’s next: Any changes to NIH indirect cost funding would now need to move through Congress.

• While the administration did not appeal the case, the President included the administration’s 15% cap in the 2027 budget proposal.
• The CAP has opposed the 15% cap.

Go deeper: Read more on the NIH indirect cost cap decision.

The White House released its fiscal year 2027 budget on April 3, proposing $111.1 billion for the Department of Health and Human Services (HHS)—a cut of more than $15.8 billion, or -12.5%, from 2026.

The administration also outlines $7 billion in one-time HHS funding rescissions that are not detailed in budget documents and may need congressional approval.

The big picture: The President again backs a major HHS restructuring, despite ongoing court challenges to his authority to reorganize without Congress.

• The plan would create an Administration for a Healthy America by combining the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, and select CDC programs.

The impact: Several HHS agencies central to CAP priorities would see notable shifts.

• CMS: The budget doesn’t directly change Medicare coverage or reimbursement, which are financed mainly through payroll taxes and premiums.
  • It highlights nearly $1.8 billion in suspended Medicare payments in 2025 through anti-fraud programs.
• FDA: More than half of FDA funding continues to come from user fees.
  • The budget proposes a $7.2 billion increase from 2026 ($3.9 billion more in user fees and $3.3 billion in discretionary funds).
  • Increased funding for the Center for Devices and Radiological Health focuses on user fee agreement requirements and expanding inspection capacity.
• CDC: The budget does not revive the 2026 proposal to eliminate the Division of Cancer Prevention and Control, which supports state cancer registries.
  • CAP advocacy helped preserve cancer registry funding in 2026, and the 2027 budget proposes $413 million for cancer prevention programs, level with 2026.
  • The budget would cut nearly $985 million from Chronic Disease Prevention and Health Promotion, reducing every program except cancer-related efforts.
• NIH: NIH faces the largest proposed HHS cut at $3.7 billion.
  • The budget does not repeat earlier plans for a major NIH restructuring.
  • It reiterates support for a 15% cap on NIH indirect costs.

Next steps: While the President’s budget signals administration priorities, Congress controls federal spending.

• HHS Secretary Robert Kennedy Jr. will testify before Congress on the department’s priorities in the coming weeks.

A coalition of medical, public health, academic, and industry organizations is urging Congress to increase funding for the CDC’s Advanced Molecular Detection (AMD) program in 2027.

Zoom in: In an April 2 letter, the groups requested $175 million annually for the CDC program, supporting genomic sequencing and advanced data analytics for infectious disease surveillance.

The AMD program enables health departments to detect and track infectious diseases using genomic sequencing.

• It’s crucial for foodborne outbreak investigations, influenza surveillance, wastewater monitoring, and antimicrobial-resistant infection responses.
• It supports pathogen genomics training and regional centers connecting research with public health practice.

Current supplemental funding is set to expire in 2027.

The impact: The coalition warns that without increased funding, genomic surveillance capacity could weaken.

• Outbreak detection and response times could suffer.
• US preparedness for emerging infectious disease threats would decline as new risks rise.