Advocacy News

• Bill to stop Medicare cuts to lab tests moves to the Senate
• Lawmakers press insurers on health care affordability
• Virginia bill targets delays to lab test results
• CMS takes measures to improve Medicare Advantage
• FDA moves to reclassify diagnostic tests
• Measles outbreak threatens US elimination status

Our focus shifts to the Senate to pass legislation that prevents Medicare cuts to clinical lab tests this year.

Late last week, the House of Representatives got the job done by passing the Consolidated Appropriations Act of 2026.

• Overall, the bill funds parts of the government through September, but it also delays cuts of up to 15% to lab tests until 2027.
• CAP members received a special update on the bill on Friday, outlining additional key health care provisions.

Next steps: Senators are discussing a vote on the bill this week.

Yes, but: While the pause on cuts are a welcome relief, additional efforts are needed for a permanent solution.

What's next: The CAP will continue urging Congress to pass the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act, which would ensure that pathologists are fairly compensated and patients have access to life-saving tests.

• We will continue to engage with lawmakers and partners to find a permanent solution to payment cuts.

Amid a flurry of activity on Capitol Hill, private health insurers answered questions in back-to-back hearings on health care affordability. On the dockets were several topics, including: 

Prior Authorization: Both parties strongly criticized prior authorization processes, urging for faster and more transparent methods. 

• What they're saying: Health care CEOs expressed their commitment to improvements, while Rep. Mike Kelly (R-PA) promoted the Improving Seniors' Timely Access to Care Act (HR 3514)—and encouraged public support from CEOs.
• CAP members can use our Action Alert Center to urge Congress to pass the Improving Seniors' Timely Access to Care Act.

Medicare Advantage: Lawmakers discussed concerns about accounts of denied Medicare Advantage requests, limited access in rural areas, and reports of plans dropping crucial rural hospitals. 

• UnitedHealth's CEO Stephen Hemsley discussed tight budgets and pilot programs for rural care.

Vertical Integration: Lawmakers expressed concern about insurers owning related health services. 

• Rep. John Joyce (R-PA) requested a list of insurance branches considered as medical or quality-improvement costs by the end of February.

What's next: These hearings mark the start of a series on health care costs. The CAP will update members on future hearings and legislation addressing rising health care expenses.

Virginia lawmakers have introduced legislation to protect patients from delays in receiving lab and pathology results.

Background: Sponsored by Asm. Destiny Bolling (D-Henrico) and Sen. Kannan Srinivasan (D-Loudon), House Bill 424 and Senate Bill 745 ensure that health carriers cannot restrict in-network providers from referring specimens or patients to any qualified laboratory or pathology service.

If passed, the legislation would remove unnecessary barriers, allowing patients to receive timely care.
The Virginia Society for Pathology (VSP) is leading efforts to support the bill.

"This bill will allow Virginia patients access to laboratories and pathologist expertise within their own communities and hospitals, supporting timely, high-quality results and holistic, patient-centered care," said VSP President Emerald O’Sullivan-Mejia, MD, FCAP.

Go deeper: The CAP also supports the bill. Read the VSP-CAP full statement.

The CAP has recommended several changes to the Medicare Advantage (MA) insurance program, including adding hospital-based specialties to network adequacy requirements, prohibiting in-network steering in the MA program, and expanding efforts to ease the burden of prior authorization.

Background: The Centers for Medicare & Medicaid Services (CMS) has asked for ways to modernize and strengthen the Medicare Advantage program.

We submitted our comments on January 26.

Go deeper: The CAP is committed to working with CMS to further enhance Medicare Advantage for patients. Read our full comment letter.

The CAP has submitted comments in response to the FDA’s reclassification of nucleic acid-based test systems. 

What we're saying: In our January 26 letter, we expressed support for the FDA's move to reclassify nucleic acid-based oncology tests. We also encourage the agency to consider reclassifying IHC and ISH tests.

Dive in: This reclassification is vital as it broadens access to diagnostic tests across the US, enhancing cancer care. The reclassification acknowledges the reliability of longstanding technologies used in these tests.

Our comments emphasize the importance of transparency in the FDA's processes, fostering trust between pathologists and patients.

• The CAP advocates for sufficient labeling of tests to aid pathologists in setting benchmarks for performance.
• This involves collaboration with drug and test developers to ensure comprehensive device labeling.

What's next: The CAP is open to assisting the FDA in reclassifying other diagnostic methods.

Measles outbreaks in several parts of the country are jeopardizing the United States’ recognition as a nation that once halted the virus’s spread.

Last week, South Carolina officials confirmed 212 new cases, raising the state total to 646. This comes amid three recently confirmed cases in Virginia.

By the numbers: The growing number of cases in South Carolina is on its way to surpassing last year’s West Texas outbreak as the largest in the United States in decades. In 2025, the US recorded 2,242 measles cases, the most since 1991.

As measles cases continue to spread, the US inches closer to losing its measles elimination status. The disease was declared eliminated in the US in 2000, and the Pan American Health Organization could revoke that status when it meets in April.

CDC officials have called the potential loss "not of grave concern" but added that "vaccination remains the most effective way to prevent measles."