Advocacy News

• What’s in the Senate's "One Big Beautiful Bill"
• CMS eases lab personnel rules with new guidance
• Lab groups: Bring back CLIAC
• Supreme Court backs no-cost preventive care panel
• Physicians unite to support vaccines
• Three ways to prepare for CAP25

After several days of negotiations and votes on amendments, the Senate passed the One Big Beautiful Bill Act early Tuesday afternoon.

Where it stands: The legislation now heads back to the House, which is scheduled to take up the Senate version this week.

• If the House can't pass the bill, both chambers will need to reconcile their differences, and they'll likely miss a July 4 target date for President Trump to sign the bill.

A key difference: The Senate bill removed the House provision to tie future Medicare physician payments to an inflation index. 

• Instead, senators added a one-time 2.5% Medicare pay bump for physicians in 2026.
• A temporary pay increase would provide some relief, but the CAP will continue to advocate for stabilization of the Medicare payment system through long-term reform.

The bill included Medicaid cuts of about $1 trillion, although senators did add a $50 billion fund for rural hospitals. 

• Student loans: Similar to the House version, the Senate bill eliminates Grad PLUS loans and caps unsubsidized borrowing for professional degrees (eg, law, medicine) at $50,000 per year ($200,000 lifetime). The CAP remains concerned with this proposal.
  • The final Senate bill did not include the provisions that would prevent medical residencies from counting toward Public Service Loan Forgiveness or allow for interest-free loan deferment for four years during medical residency.

The big picture: Members of the House will need to decide whether to accept these and other changes, as lawmakers are under pressure to pass the bill by the deadline.

The Centers for Medicare and Medicaid Services (CMS) issued guidance clarifying regulatory changes from the 2023 CLIA Personnel Rule, which took effect in December 2024. The updates outline how the agency will apply enforcement discretion and new flexibility in qualification requirements. 

This guidance affects laboratory directors, clinical consultants, and technical supervisors. 

Clarifications:

• Moderate complexity laboratory directors can qualify with either one year of supervision experience or 20 CE credit hours—both are not needed. We advocated for this change in our deregulatory relief recommendations.
• Clinical consultants who were previously qualified can continue in that role without needing additional CE credits.
• Technical supervisors qualify as high-complexity laboratory directors for dermatopathology testing.
• High-complexity lab directors with a doctoral degree need only two years (down from four years) of training or experience. 

What's next: CMS intends to formalize these updates in future notice-and-comment rulemaking, during which the CAP can provide feedback. 

Dive in: Read the full memo.

The CAP, the Association of Public Health Laboratories, and other leading organizations are urging HHS to reinstate the Clinical Laboratory Improvement Advisory Committee (CLIAC). 

Where it stands: CLIAC was dissolved as part of a broader restructuring by HHS that eliminated several federal advisory committees.

What they're saying: In a letter signed on June 30 by 27 organizations representing clinical and public health laboratories, the groups call on HHS to reinstate CLIAC and hold a meeting in November. 

• CLIAC offers expert recommendations to federal agencies on lab regulations.
• Without it, lab regulations risk becoming outdated and disconnected with current laboratory practice.
• Eliminating CLIAC could weaken the health care system and compromise quality of testing.

The Supreme Court has upheld the legal authority of a federal health task force that recommends preventive services which must be covered without out-of-pocket costs under the Affordable Care Act. 

Details: The ruling in Kennedy v. Braidwood Management confirms the constitutionality of the role of the US Preventive Services Task Force (USPSTF) within HHS. 

• The USPSTF issues recommendations that require insurance coverage for cancer screenings and other diseases.
• The 6–3 decision maintains the authority of the USPSTF to recommend preventive services for coverage at no cost to patients.

The bottom line: The ruling preserves a cornerstone of the ACA, ensuring continued access to preventive services without financial barriers.

The CAP joined the American Medical Association and other medical organizations in reaffirming their support for vaccinations. 

What they're saying: A joint letter, signed by 80 groups and released ahead of the Advisory Committee on Immunization Practices meeting on June 25, emphasized the importance of vaccines to protect against respiratory viruses. 

• Federal officials, led by HHS Secretary Robert F. Kennedy Jr., are re-examining and questioning vaccine efficacy and vaccine schedules for children.
• Recent changes to federal immunization review processes have further raised concerns across the medical and public health community. 

The bottom line: Physicians are united in support of evidence-based immunizations to prevent severe disease and protect public health.

The long weekend is almost here, and it's the perfect time to start preparing for CAP25! Here are three ways to prepare for the CAP annual meeting, happening September 13–16:

• Register: Secure your spot for CAP25 now.
• Set your schedule: Plan your sessions in advance and get to know our expert faculty.
• Spread the word: Invite your colleagues to join you at CAP25 and share your participation on social media!

I Belong at CAP25