Advocacy News

• Preview: House of Delegates & Pathologists Leadership Summit
• Pathology leaders align on 2026 advocacy priorities
• CAP presses HHS for transparent, safe use of AI in health care
• CAP voices concerns on HTI-5 rule
• FDA modernization proposals target AI, digital tools
• House hearing targets physician workforce crisis
• 2024 MIPS pay adjustment: Check your QPP account

Just announced: Get an exclusive preview of the House of Delegates / Pathologists Leadership Summit 2026 advocacy program during a webinar on March 11 at 5:00 PM ET. 

• Join CAP staff to learn how to prepare for our annual Hill Day, navigate Capitol Hill visits with confidence, and make your voice count. 

Register here to join the conversation.

A meeting with national pathology organizations took place on February 27 to discuss key advocacy priorities for 2026.

The impact: Leaders from across pathology discussed workforce shortages, Medicare payment, coverage policies, and other pressure points for the specialty.

• The groups discussed ongoing efforts to exempt physicians from new rules imposing a $100,000 application fee for an H-1B visa.
• Groups participating in the meeting had requested the H1-B exemption last October in a letter to the Department of Homeland Security. 

In addition to the CAP, the meeting included representatives from the American Society of Cytopathology, the American Society for Clinical Pathology, the American Society for Dermatopathology, the Association for Academic Pathology, the Association for Molecular Pathology, and the National Association of Medical Examiners.

Overall, their shared goal is to protect patient access to high-quality laboratory and pathology services through legislative and regulatory advocacy.

Next steps: The organizations will continue joint advocacy to shape policy changes and strengthen the pathology specialty.

• We’ll keep you updated as these efforts advance.

With AI rapidly growing in influence over multiple economic sectors, the CAP has made strong recommendations for health regulators to consider when looking to adopt AI in pathology and laboratory medicine.

The backdrop: The Department of Health and Human Services (HHS) issued a request for information on accelerating the adoption and use of AI in clinical care.

The CAP’s comments, submitted on February 23, focused on safe, effective, and innovative ways AI can strengthen laboratory medicine.

What we’re saying: We emphasized AI’s potential to enhance clinical care while preserving high standards in laboratory medicine.

The impact: Our recommendations to HHS focus on:

• Preserving essential, complementary roles for FDA review of AI-enabled medical devices and software, and CLIA oversight of laboratories.
• Applying lessons from the CAP’s laboratory accreditation experience to AI oversight and quality.
• Ensuring pathologists lead in the selection, validation, and use of AI systems in the laboratory.

The bottom line: The CAP will work with HHS to integrate AI into health care responsibly so tools are reliable, safe, and beneficial for patients and health care teams.

Go deeper: Read our full response.

The Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP) has called for comment on the HTI-5 Proposed Rule.

The CAP submitted comments on the ASTP’s HTI-5 Proposed Rule, emphasizing support for interoperability but expressing concerns.

What we’re saying: Our comments highlight the importance of transparency and patient safety in AI-enabled health IT systems, which affects laboratory practices and patient care.

• Pathologists need clear information to trust and effectively use AI technologies in labs, ensuring safe and ethical implementation.

Decision support interventions: The CAP argues against rescinding informational requirements for AI systems, emphasizing that transparency is crucial for effective AI adoption and preventing misuse.

Information blocking: The CAP supports patient access to test results but cautions against immediate release without clinician review, as it may lead to misinterpretation and distress.

• Our recommendations include a blanket exception to allow clinician input before releasing pathology and laboratory test results, ensuring better care coordination and patient understanding.

The bottom line: The CAP is committed to collaborating with ASTP and other stakeholders to enhance health IT while safeguarding patient care and trust in medical systems.

Dive in: Read our full comments.

A new Senate report outlines legislative and regulatory reforms to modernize the FDA.

Zoom in: The Senate Health, Education, Labor, and Pensions (HELP) Committee released Patients and Families First: Building the FDA of the Future Patients.

• The report targets FDA policies on AI, clinical decision support, real-world evidence, and digital health in clinical trials.

What they’re saying: "While many parts of FDA work well, unnecessary bottlenecks slow patients and consumers getting the products they need," said Sen. Bill Cassidy, MD (R-LA), HELP Committee chair.

Here are highlights from the report:

• AI regulation: Supports a risk-based approach focused on high-risk AI uses without slowing innovation and calls for better coordination across HHS and National Institutes of Standards and Technology.
• Clinical decision support (CDS): Reaffirms that Congress excluded many CDS tools from FDA oversight and urges the FDA to stay within clear statutory boundaries.
• Real-world evidence: Emphasizes the need for more clarity and consistency in how the FDA evaluates nontraditional data sources.
• Digital health in clinical trials: Raises concerns about applying device-level standards to non-device tools, such as wearables.

Go deeper: Read the full HELP Committee report.

The House Ways and Means Subcommittee on Health held a hearing on the looming health care workforce shortage, including a projected deficit of 187,000 physicians by 2037.

By the numbers: The shortage already threatens access to essential services, especially in rural communities.

• Rural areas have about 60% fewer physicians per 10,000 patients than urban areas.

Our advocacy: The CAP has long advocated for policies to strengthen the physician workforce pathway.

The big picture: Graduate medical education (GME) is central to building the workforce, but funding patterns disadvantage rural training.

• Urban hospitals have received 97% of new GME slots, despite Congress reserving positions for rural areas.
• Lawmakers from both parties signaled support for adding rural residency spots, extending federal startup funding for rural programs, and increasing transparency in GME funding.

Zoom in: Lawmakers also surfaced additional threats to workforce growth.

• Possible Medicaid cuts, a proposed $100,000 H-1B visa fee for international medical graduates, and tighter student loan limits all raised red flags.
• The CAP joined the AMA in opposing the proposed visa fee.
• We have also raised concerns about student loan caps.

Performance year 2024 Medicare Merit-based Incentive Payment System (MIPS) payment adjustments are now affecting reimbursements in 2026.

Practices that participated in MIPS in 2024 should review remittance advice (RA) documents to confirm the Centers for Medicare & Medicaid Services (CMS) is applying adjustments correctly. 

• CMS errors could lead to underpayments or overpayments.

The impact: Your remittance advice should clearly show whether you’re receiving a positive or negative MIPS adjustment.

• If you earned a positive payment adjustment: Look for Claim Adjustment Reason Code (CARC) 144 on your RA for "Incentive adjustment, e.g., preferred product/service."
• If you’re getting a negative payment adjustment: Look for CARC 237 on your RA for "Legislated/Regulatory Penalty. At least one Remark Code must be provided (may be comprised of either the National Council for Prescription Drug Programs (NCPDP) Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)."

Next steps: Not sure whether you should see a positive or negative adjustment?

• Check your final PY 2024 MIPS score at qpp.cms.gov.
• Sign in, select Performance Feedback on the left, then open the caret next to Download Data to get your Payment Adjustment CSV file.

Questions? If you think your payment adjustment is incorrect, email the CMS at qpp@cms.hhs.gov or the CAP at mips@cap.org for help.