Advocacy News

• Prior authorization bill nears milestone in the House
• House panel to examine Medicare physician payment reforms
• CAP signs on to Medicare payment reform letter
• FDA leadership shift raises questions for labs

The Improving Seniors' Timely Access to Care Act (S 1816/HR 3514) is just a few co-sponsors away from hitting two-thirds support in the House of Representatives.

• 290 co-sponsors is a symbolic "magic number" as it’s a threshold for overriding a presidential veto and passing certain other appropriations.
• As of today, HR 3514 has 283 co-sponsors after Reps. Sheri Biggs (R-SC) and Brian Babin (R-TX) signed on to the bill last Wednesday.

The CAP has supported the bill’s passage since it was introduced almost a year ago.

• We've asked pathologists to use our Action Center to encourage lawmakers to pass the bill. 

Background: The zero-cost bill would simplify the prior authorization process in Medicare Advantage and improve access to care for more than 32.8 million seniors.

The impact: Streamlined prior authorization would allow physicians to spend more time on patient care and less on administrative red tape.

Key provisions: The bill would codify and strengthen CMS’ 2024 electronic prior authorization rule.

• It pushes Medicare Advantage plans toward faster electronic processes rather than manual approvals.
• It aims to standardize, automate, and make prior authorization more transparent, reducing inappropriate denials.

The bill has earned strong bipartisan backing in past Congresses, including unanimous House passage in 2022.

This Wednesday, the House Energy & Commerce Subcommittee on Health will hold a hearing on Medicare physician payment reform.

The big picture: Lawmakers will review the Medicare Physician Fee Schedule, quality programs, and options to stabilize payments and protect seniors’ access to care.

• The hearing will examine how a 2015 law, the Medicare Access and CHIP Reauthorization Act, has changed physician payment, contributed to ongoing instability in Medicare rates, and increased regulatory burdens.
• Lawmakers will seek policy solutions to reduce uncertainty for physicians and support consistent care for Medicare beneficiaries.

The hearing aims to advance reforms that move beyond short-term "doc fixes" and strengthen long-term access to care.

Go deeper: You can watch the hearing live Wednesday at 2 p.m. ET. 

The CAP joined an American Medical Association (AMA) Federation sign-on letter supporting H.R. 8163, the Provider Reimbursement Stability Act, aimed at addressing instability in the Medicare Physician Fee Schedule (MPFS).

The impact: The bill would improve payment accuracy for physician services and help stabilize the MPFS. Medicare physician payment has not kept pace with inflation or rising practice costs, creating continued pressure on physician practices and patient access to care.

What's in the bill:

•    Modernizes Medicare budget neutrality policies.
•    Improves the accuracy of practice expense updates.
•    Increases predictability in physician payment.

What's next: We'll share the full sign-on letter once it becomes available.

A leadership change at the Food and Drug Administration (FDA) is drawing close attention across the health care sector.

The latest: FDA Commissioner Marty Makary, MD, resigned on May 12 after a 13-month tenure marked by internal tension and policy disputes.

The impact: FDA decisions shape oversight of diagnostics, emerging technologies, and review pathways that affect how labs bring tests to patients.

The backstory: His tenure drew criticism from multiple groups over vaccine policy, drug approvals, and regulatory decisions that some viewed as inconsistent.

The CAP view: Stability and transparency at the FDA are key to ensuring predictable regulatory pathways that support patient care and innovation.

What’s next: Deputy Commissioner for Food Kyle Diamantas will serve as acting commissioner while a permanent replacement is considered.