Advocacy News

• RESULTS Act would secure lab services, members asked to comment
• House passes stopgap, Sept. 30 shutdown deadline looms
• CAP wants CMS to abandon proposed cuts to pathology services
• White House to curb H-1B visas but might exempt physicians from fees
• CAP, others send letter to CMS: Expand MIPS quality measures
• Grants will help CAP improve pathology reports for some patients
• Drs. Booth, Gibson join panel to advocate for molecular testing coverage
• New advocacy guide available to state societies, get yours today!

The Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act, introduced on September 10 seeks to stabilize laboratory services by addressing flawed data collection under the Protecting Access to Medicare Act (PAMA).

What's at stake: Without intervention, laboratories face drastic cuts of up to 15% in January 2026, threatening access to commonly ordered test services for Medicare patients.

• The first round of data collection in 2017 underrepresented hospital outreach and physician office laboratories, leading to nearly $4 billion in cuts.
• Congress has already intervened multiple times to delay reporting periods and cuts to maintain access.

What's next: The CAP urges Congress to pass the RESULTS Act to prevent needless loss of access to care and support critical laboratory infrastructure.

• CAP members can also show their support by asking Congress to pass the bill.

With a vote of 217-212, the House passed a stopgap bill on Friday to keep the federal government funded for an additional seven weeks. 

• The bill still needs to pass the Senate to avoid a shutdown at the end of this month. 

Yes, but: The bill stalled in the Senate with Democrats blocking it from moving forward. 

• An alternative funding bill offered by Democrats was also blocked by Senate Republicans.

What's next: The Senate is scheduled to be in recess until September 29. There will be a government shutdown unless Congress can reach an agreement by September 30.

The CAP told the CMS to abandon proposals that will reduce payment for pathology services in 2026.

We’re vigorously opposing adjustments for efficiency and practice expenses in our formal comments to the proposed 2026 Medicare Physician Fee Schedule submitted on September 11. 

Efficiency adjustments are 2.5% across-the-board cut to physician work values and intra-service time for more than 7,000 services, including pathology.

• These are not based on new data or physician input, but on an assumed "efficiency."

Practice expense adjustments will reduce facility practice expense pay, disproportionately harming transfusion medicine and pathology services.

• These changes would create dramatic impacts across the health care system.

Next steps: The CMS will review and consider all submitted comments before determining whether and how to finalize its proposed policies, with the final rule scheduled for release in early November.

Go deeper: Watch a webinar on Medicare changes for 2026.

The Trump administration is restricting H-1B visas by requiring a $100,000 payment during the application process, which went into effect on September 21.

The impact: The pathology specialty is concerned with this change, as about 8% of pathologists responding to the 2024 Practice Characteristics Survey indicated they’ve held an H1-B at some point.

What they're saying: "Those who already hold H-1B visas and are currently outside of the country right now will not be charged $100,000 to re-enter," said White House Press Secretary Karoline Leavitt. 

• Leavitt added that H-1B visa holders can leave and re-enter the US to the same extent as they normally would. 

The Department of Homeland Security will be empowered to make exemptions and waive the fee for visa applications in the national interest.

• The White House specifically mentioned physicians may qualify for exemptions.

The CAP joined other medical organizations to state concerns over the CMS' process for reviewing and selecting quality measures for the Merit-based Incentive Payment System (MIPS).

Zoom in: In a letter, the groups urged the CMS to reevaluate its measure inclusion process, revive the quality clinical data registry option, and ensure a robust suite of MIPS Value Pathways (MVPs).

Aligning more measures with episode-based cost measures and alternative payment models is crucial for providing quality information to patients and supporting physicians' success in CMS programs.

• Yes, but: A reduced number of measures isn't the issue; it's the complexity and duplication in reporting requirements that burdens physicians.

The big picture: the CMS' move to combine multiple measures into composites increases complexity, making it harder for physicians to access useful data and improve patient care.

• Disease-specific measures, especially in specialties like rheumatology, are at risk as combining different disease assessments may not be clinically appropriate.

The CAP will update members as more information becomes available.

The CAP received two consecutive grants from the Council of Medical Specialty Societies (CMSS) to improve pathology reports for patients with colorectal cancer as part of a multi-specialty collaboration. 

• The CMSS awarded the CAP grants on a patient-centered pathology report and promoting effective communication of pathology results.

The impact: By surveying and interviewing patients and other members of the care team, including surgeons, oncologists, and gastroenterologists, the CAP developed recommendations to improve pathology reports.

• The recommendations don’t compromise the necessary clinical information treating clinicians require.

While the two grants are completed, the work of this project is ongoing and represents the CAP’s commitment to improving care for all patients across the health care system.

Next Steps: The CAP is convening a group to help implement these recommendations and develop resources without increasing the burden on pathologists.

Go deeper: Read the CMSS project summary, the CAP-specific project summary, and a recent editorial by lead author, Diana Cardona, MD, FCAP, about the work.

As part of the CAP's ongoing advocacy, members Joanna Gibson, MD, PhD, FCAP, and Adam Booth, MD, FCAP, were part of eleven panelists who participated in a discussion of Molecular Testing for Detection of Upper Gastrointestinal Metaplasia, Dysplasia, Neoplasia on September 4.

The meeting was hosted by four Medicare Administrative Contractors (MACs) Palmetto GBS, Noridian Healthcare Solutions, CIGNA Government Services, and Wisconsin Physicians Service. Currently, these MACs do not cover molecular testing to detect changes in the cells of the upper digestive tract.

Dr. Gibson, Dr. Booth, and other panelists discussed the current medical evidence and clinical practice regarding testing to determine if the current policy should allow for molecular testing.

Are you a State Society President? The CAP has a new State Advocacy Guide with you in mind!

The guide is designed to assist you in your role as the president of your state pathology society. It will expand your knowledge about state government, dos and don'ts, and how the CAP supports your advocacy on the local level.

Submit a request to access the guide today!