Advocacy News

• Dr. Zhai: Advocacy that delivers results for pathology and laboratories
• Clinical lab data collection reporting starts May 1
• CAP highlights pathologist oversight and patient safety in AI adoption
• Pathologists advocate for value-based care
• PathPEF Advocacy Award open to pathology residents
• Lawmakers slate trio of hearings

By Qihui “Jim” Zhai, MD, FCAP, CAP President

We reached a significant milestone last week when federal lawmakers enacted legislation to keep the government open through September. Tucked inside the bill was a provision supported by the CAP that stops Medicare cuts to clinical laboratory tests in 2026.

That’s right. No cuts in 2026.

For the CAP, preventing payment cuts is always a top priority. We do everything we can to protect the value of pathology and laboratory medicine services.

We don’t do this work alone. It takes close coordination with our colleagues across organized medicine. Just as important, pathologists play an integral role in explaining to federal officials the value of the work we do for patients. These discussions shape health care policy for years to come.

That advocacy makes a difference. Almost a year ago, about 140 pathologists and I went to Capitol Hill to ask representatives and senators for relief from Medicare cuts. We shared our stories about how future cuts would affect patient care and what Congress could do to help.

Congress listened.

Now, we must keep showing up. After stopping these lab cuts last week, we are redoubling our efforts to address cuts to Medicare physician reimbursement. We need your voice and your presence to help drive change in Washington once again.

This April, we will return for the House of Delegates & Pathologists Leadership Summit 2026 and the CAP Hill Day. Once again, we’ll talk to Congress about the work we do and the patients we care for. 

I hope you'll be there with me.

Register and Advocate

Last week, Congress passed the Consolidated Appropriations Act of 2026, delaying the planned 2026 Medicare cuts to lab tests (up to 15%) until 2027. Clinical labs must now focus on upcoming programmatic requirements.

Zoom in: Certain laboratories must prepare to collect and send data to the government regarding the private payer rates they receive for tests. These data will then be used to calculate new fees for tests on Medicare's Clinical Laboratory Fee Schedule.

• The required data will be the rates clinical labs received for tests between January 1 and June 30, 2025.
• Laboratories are expected to send these data to the Centers for Medicare & Medicaid Services (CMS) between May 1 and July 31, 2026. 

Yes, but: Laboratories should first assess if they meet the definition of an “applicable laboratory” under the revised rules.

Watch: Medicare Learning Network: Is My Lab an Applicable Lab?

What’s next: CMS will release resources and fact sheets to aid in data submission in the coming months.

• Labs should begin gathering the necessary data and assessing their readiness to meet new requirements.

Download: We’ve developed a two-page resource answering questions about the data collection and reporting process. 

Looking ahead: The CAP will continue to ask Congress to minimize these administrative burdens on labs by passing RESULTS Act.

Following last week’s House hearing on AI adoption in the workplace, the CAP submitted comments emphasizing that strong pathologist oversight and patient safety must remain central to such adoption. 

What we’re saying: Our comments underscore the role of AI in enhancing pathologists' diagnostic capabilities while emphasizing patient safety and clinical validity.

• AI tools can extend analysis and provide additional insights, but the final diagnosis and patient care decisions must remain in the hands of pathologists.
• AI aids in screening and analyzing samples but is designed to support, not replace, human expertise.

Challenges in AI implementation: The CAP also identified potential issues, including AI hallucinations, biases, and overfitting, that would require mitigation.

• Pathologists must oversee AI systems, ensuring that ethical considerations and performance quality are maintained.

Federal policy recommendations: The CAP advises that legislation should focus on patient safety and clinical validity, and avoid duplicating existing regulations. Investments in digital infrastructure and workforce training are essential for AI's success in pathology.

Go deeper: Read our full comments.

Last week, members of the CAP’s Value-Based Programs and Healthcare Policy Committee and the Council on Government and Professional Affairs met with staff from the Center for Medicare and Medicaid Innovation (CMMI) to underscore the importance of pathology in value-based care. 

• CMMI develops alternative payment models (APMs) to improve the quality of care for Medicare beneficiaries while reducing costs. 

What we said: CAP leaders helped CMMI understand the important contributions pathologists make to early disease detection, which is key not only to earlier intervention but also to managing the costs of care. 

• In turn, CMMI staff indicated openness to collaboration and highlighted the value of specialty societies in implementing and monitoring models.

What’s next: CMMI recognizes the importance of improving and maintaining quality care for Medicare beneficiaries and suggests that the CAP could help identify gaps in the quality measurement set.

• A future meeting is planned with CMMI’s quality measure experts to discuss priorities for measuring pathology in APMs.

Pathology residents are encouraged to apply for the PathPEF: Resident Advocacy Development Award.

Funded by PathPAC's Political Education Fund (PEF), the Resident Advocacy Development Award offers pathology residents a unique opportunity to attend the CAP's House of Delegates & Pathologists Leadership Summit and participate in Hill Day in Washington, DC.

The award is open to all pathology residents actively enrolled in an accredited US pathology residency program. The application deadline is March 16.

Find out more about supporting PathPEF online.

Tomorrow, February 11, lawmakers will hold three key health care hearings. The hearings will examine policies affecting veterans’ access to care and broader pressures on the physician workforce.

The scheduled hearings are:

• House Veterans’ Affairs Committee hearing, Opportunities With VHA Reorganization, 10:15 AM ET
• Senate Special Committee on Aging, Hearings to Examine How Washington’s Rules Drove Physicians Out of Medicine, 3:00 PM ET
• Senate Veterans’ Affairs Committee, Hearings to Examine Building a 21st Century VA Health Care System, 4:00 PM ET

The CAP will share updates on any pertinent policies as information becomes available.