Advocacy News

• CAP, New York pathologists push back on scope-of-practice creep
• CAP raises cytology policy questions with CMS
• Connect with peers at pathology State Leaders Meet & Greet
• House hearing targets rural physician shortages and GME reform
• Federal anti-fraud effort will look at lab services
• USPSTF meeting canceled again

The CAP and the New York State Society of Pathologists (NYSSP) are opposing a New York State Department of Health proposal that would expand histotechnologist duties with only "minimal supervision."

• The proposal would allow histotechnologists to "process histopathology specimens … with minimal supervision by the laboratory director, technical director, or supervisor."

The impact: We’ve cautioned New York regulators that this language weakens patient safety protections around grossing.

• CAP and NYSSP are urging the state to revise the scope so that "grossing of pathology specimens be conducted under direct supervision by a licensed physician who practices anatomic pathology."
• We emphasize that macroscopic examination and dissection ("grossing") are high-complexity testing steps that influence diagnosis and treatment decisions.

What we're saying: "We believe quality laboratory medicine in New York is best served by adoption of the proposed regulatory amendment as submitted by NYSSP," wrote CAP President Qihui "Jim" Zhai, MD, FCAP.

Next steps: The New York State Department of Health will review all submitted comments before issuing a final rule.

Go deeper: Our comments point to existing law and national standards that recognize the need for direct physician oversight.

• Read CAP's full regulatory comment letter.
• Review the NYSSP position statement.

The CAP recently met with CMS to discuss questions from the pathology community about policy changes affecting remote review of digital cytology.

The backstory: CMS announced the policy update in September 2025 as part of revised CLIA guidance. The change clarifies that after March 23 of this year, a CLIA certificate will be required to conduct remote cytology screening at any given location.

The CAP view: The CAP requested the meeting to share questions raised by pathologists and laboratories as they prepare for the policy to take effect.

The bottom line: CMS thanked the CAP for raising community concerns as laboratories prepare for the change.

Go deeper: Read the updated CMS guidance on digital cytology and CLIA requirements. 

State leaders and delegation chairs are invited to a State Leaders Meet & Greet on Saturday, April 25, during the House of Delegates & Pathologists Leadership Summit 2026 in Washington, DC.

Co-hosted by the CAP House of Delegates and the Council on Government and Professional Affairs State Pathology Society Subcommittee, the event gives you time to:

• Connect with peers from across the country.
• Exchange ideas on state advocacy and leadership.
• Strengthen relationships that support your work at home.

The big picture: The Meet & Greet sets the stage for Sunday’s House of Delegates program, which will feature an interactive community-building session.

• You'll explore practical strategies to strengthen state societies and deepen member engagement.
• The session is designed to spark discussion, surface real-world tactics, and help you bring fresh, actionable ideas back to your community.

On February 24, the House Ways and Means Health Subcommittee held a hearing on “Advancing the Next Generation of America’s Health Care Workforce,” with a sharp focus on physician shortages in rural and underserved areas.

The impact: Members from both parties signaled interest in expanding and better targeting GME to address workforce gaps that affect access to care for your patients.

• Rural areas have far fewer physicians per capita, yet only about 2% of residency programs are based in rural communities.
• Witnesses stressed that physicians are much more likely to practice in rural areas if they complete residency there.
• Persistent barriers include 1990s-era Medicare GME caps, limited rural training infrastructure, high startup costs for new programs, and the cost of medical education.

Key provisions: Ideas and proposals discussed during the hearing included:

• Rural residency growth: Members in both parties voiced support for adding rural residency slots, extending federal startup support for rural programs, and ensuring Medicare payment policies don’t disadvantage rural hospitals.
• Resident Physician Shortage Reduction Act: Several promoted this bipartisan bill to add 14,000 new Medicare-supported residency positions over seven years.

Take action: You can use our Action Center to send a message about physician workforce issues to your representatives. 

Between the lines: The hearing also surfaced partisan fault lines that could shape future workforce and GME legislation.

• International medical graduates (IMGs): Members discussed the $100,000 H-1B visa supplemental fee, which took effect for new applications filed after September 21 of last year, and questioned witnesses regarding the parameters of a potential physician visa exemption as well as broader physician visa policy.
• Some noted IMGs are disproportionately likely to serve in rural and high-poverty communities.

The big picture: Lawmakers broadly agreed that the current GME system, built on outdated caps and urban-centered funding formulas, is not delivering enough primary care, pediatric, and rural physicians.

Go deeper: Re-watch the hearing.

The Centers for Medicare & Medicaid Services (CMS) anti-fraud and waste initiative, called "CRUSH," is asking the public for tips on how to find savings and eliminate fraud in federal health programs like Medicare and Medicaid.

The impact: The request for more information from the public mentions laboratory testing, including genetic and molecular diagnostic tests.

• Genetic tests made up 5% of Part B lab tests in 2024 but drove 43% of spending—$3.6 billion.
• For pathologists and labs, CMS’ focus could affect future coverage, payment, and documentation expectations for high-cost molecular and genetic tests.

The bottom line: CMS is making laboratory fraud a priority and wants stakeholders to address program integrity concerns, including MolDX program challenges. 

The Medicare agency is signaling a strong push to curb unnecessary spending.

Next steps:

• The CAP will be responding with its own comments by the March 30 deadline.
• Consider coordinating with your practice or institution on whether, and how, you’ll provide input as well.
• Review the full request for information and submit feedback by the deadline.

The March meeting of the US Preventive Services Task Force (USPSTF) was canceled for a third time. HHS said the meeting will be rescheduled in the coming months.

The backstory: The proposed agenda included a discussion regarding self-collection for human papillomavirus (HPV) cervical cancer screening.

The impact: The USPSTF, created by statute and meeting for about 40 years, plays a key role in preventive care coverage requirements under the Affordable Care Act. The task force did not issue its annual research report to Congress in 2025 and has open seats following member departures last year.