Advocacy News

• Medical coalition urges Congress to pass RESULTS Act
• Urgent call to halt CMS cuts by January
• Members needed to tell Congress to protect patients; some will "fly-in" Wednesday
• CAP to DHS: Pathologists, lab pros should be exempt from H-1B visa fee
• Missouri members champion advocacy and clinical excellence
• AHA urges delay on WISeR model
• Monkeypox alert: New cases in Southern California

The CAP and a coalition of leading organizations representing laboratories, physicians, hospitals, diagnostic manufacturers, and others are urging Congress to enact the RESULTS Act to safeguard patient access to clinical laboratory services.

Background: The Medicare Clinical Laboratory Fee Schedule (CLFS) sets payment for lab services, and pathologists around the country worry that the next round of cuts could affect patient care.

• The RESULTS Act aims to reform CLFS by using comprehensive market data to set lab fees. 

The backdrop: Historical data inaccuracies have led to significant payment cuts, with less than 1% of labs’ private payor data influencing rates.

If passed, the RESULTS Act would: 

• Direct the CMS to contract with an independent, not-for-profit commercial claims database for widely available lab tests.
• Exclude Medicaid managed care rates, which are not reflective of market values, for setting lab fees.
• Place a cap on annual payment reductions to prevent destabilizing cuts.

What's next: Congress must act now to prevent the 15% payment cuts on January 1.

Take action: Join your colleagues in using our Action Center to ask your elected officials to stop the cuts and pass the RESULTS Act.

Days after CMS released its final 2026 Medicare Fee Schedule, the CAP has joined 33 other medical societies in asking Congress to stop Medicare’s planned "efficiency adjustment" that cuts physician reimbursements by 2.5%, with additional reductions expected every three years.

This adjustment will slash Medicare pay, affecting patient access to care among vulnerable groups.

• The policy assumes efficiency gains that aren’t universally applicable, potentially destabilizing physician compensation and employment contracts.
• Once implemented, the policy could lead to consolidation, affecting solo practitioners and small practices.

In a separate letter to congressional leadership, the CAP also emphasized that the policy overlooks the actual workload and cognitive demands placed on pathologists. This adjustment doesn't account for modern medical practice, including increased patient complexity and emerging technologies.

• Such a cut could result in tens of millions of dollars in losses for pathology diagnostic services.
• Congressional action is needed to halt these harmful cuts before January 1.

Looming cuts to pathology services, tariffs on medical supplies, physician shortages, and other issues are affecting pathologists and laboratories nationwide. Without congressional action, these issues will have a detrimental effect on your labs and your patients. 

Now is the time to contact your members of Congress.

This Wednesday, invited CAP members in key Congressional districts will participate in a virtual fly-in to meet with federal lawmakers and to advocate for critical issues affecting pathologists, laboratory medicine, and patients. While these members participate in the fly-in, all CAP members can raise their voices using the action alerts below.

Contact Congress: Use these Action Alerts today to tell your federal lawmakers to:

• Support the RESULTS Act to stabilize laboratory services and stop Medicare payment cuts.
• Reform the current Medicare payment model.

Other asks: 

• Address the physician workforce shortage by supporting legislation that boosts the number of doctors practicing in the United States.
• Oppose the Patent Eligibility Restoration Act. We must stop this legislation that would allow the patenting of human genes and naturally occurring associations between genes and disease.
• Reform prior authorization. We need Congress to support legislation that reduces burdensome prior authorization requirements that interfere with both your practice and patient access to pathology services.

Sending an Action Alert only takes a few clicks. 

• Use our step-by-step tutorial to send your alert and act now on these issues.

The CAP and other leading laboratory organizations want the US Department of Homeland Security to exempt pathologists and lab professionals from a $100,000 H-1B visa fee. 

What they're saying: In the letter, the groups warn that the steep fee would strain the health care system, especially smaller hospitals and labs in underserved areas that rely on international medical graduates (IMGs) to fill critical workforce gaps, threatening patient care and access to crucial lab services.

• The CAP previously joined other medical societies in calling for a fair and efficient immigration system that provides a pathway for international physicians.

The big picture: The US faces a critical shortage of pathologists and lab professionals. The demand for pathologists exceeds supply, with only about 600 new pathologists entering practice each year, which is insufficient to meet the growing demand for diagnostic and laboratory services nationwide. The H-1B visa is essential to addressing these shortages, allowing visa holders to provide the necessary care. 

The Missouri Society of Pathologists held its annual meeting in late October, featuring presentations by CAP members Adam L. Booth, MD, FCAP; Chakshu Gupta, MD, FCAP; and Matthew G. Hanna, MD, FCAP. 

The program highlighted key advocacy updates and clinical advancements in partnership with the CAP, emphasizing the vital role of state and national collaboration in strengthening the voice of pathology.

Learn more: Check out the CAP’s State Pathology Societies resources. 

The American Hospital Association (AHA) has recommended changes to the Centers for Medicare & Medicaid Services' (CMS) Wasteful and Inappropriate Services Reduction (WISeR) model.

The AHA expressed several concerns about the WISeR model, including appeal rights, oversight on the use of AI, expansion of the model’s scope, its payment structure for participating vendors, oversight of vendors used by Medicare Advantage plans, and its implementation timeline. The AHA urged CMS to delay its implementation by at least six months.

What's next: The model is scheduled to begin on January 1 and will be conducted in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. 

Dive in: Read the AHA comments. 

Three unrelated cases of clade I monkeypox virus were found in Southern California, suggesting a potential community spread in the US.

Zoom In: The CDC reports that the cases have no travel history or common exposure, indicating possible local transmission, and continues to assess the risk of clade I MPXV to the US general population as low. 
State, local, and territorial public health authorities should promptly report cases to CDC, including orthopoxvirus generic (ie, non-variola orthopoxvirus) positive and clade II negative test results from patients.

• Increased surveillance and investigations are ongoing, with no additional cases identified so far.
• The CDC’s current clade typing is limited due to resource constraints.
• Non-CDC labs should notify state health departments if clade I MPXV is detected.

Guidance for clinicians:

• Be aware of MPXV symptoms and inquire about patient travel history and risk factors.
• Report suspected cases to local and state public health authorities immediately.
• Consider MPXV testing and vaccination as recommended by the CDC.

Additional resources: Check HAN Health Update 516 for the latest CDC guidance and travel advisories.