June 26, 2026
Federal Independent Dispute Resolution Operations Final Rule (CMS)
Note that the CAP does not endorse, support or oppose any candidate for public office.
Transcript
Nick Lanyi
My updates to the No Surprises Act are great news for pathologists. The CAP speaks out against a proposed rule that could harm scientific journals. And could there be a pathologist in the house? These stories and more coming up next. This is Path News Network Daily Edition from the College of American Pathologists. I'm Nick Lanyi. It's Friday, June 26th. The Federal No Surprises Act limits patients' vulnerability to getting unexpected medical bills from out-of-network providers. But the implementation of the 2022 law made it difficult for some providers, including pathologists, to dispute insurer payments. Dr. Stephen Black- Schaffer, pathologist at Massachusetts General Hospital in Boston and chair of the CAP's Policy Roundtable Subcommittee, told us why pathologists in particular will benefit from updates to the law announced last month.
Dr. Black-Schaffer
We generate many small charges, typically for individual specimen services. And as a result, efforts to moderate the influence of insurance companies on the dispute process when there is a disagreement about payments need to be adjusted so that it's actually practical for somebody to bring forward disputes over multiple small charges as opposed to single big charges such as hospitals and some other clinical providers would have to deal with.
Nick Lanyi
After years of advocacy, the CAP succeeded in getting the federal government to update its rules. Several of these were specifically requested by the CAP, and they will especially benefit pathology practices, Dr. Black- Schaffer said.
Dr. Black-Schaffer
One I would mention is a reduced administrative fee from $150 to $15 for initiating a dispute resolution. That makes a big difference because obviously, if the total charges you're talking about aren't that much different than $150, that payment up front certainly inhibits your ability to actually effectively dispute unreasonable reductions or non-payments.
Nick Lanyi
The new rules also raise the number of claims that can be batched together from 25 to 50 — another key for pathologists, who often generate several low-cost claims from a single patient visit or procedure. Dr. Black-Schaffer credited the CAP's advocacy staff with working hard over a long period to achieve a positive result.
Dr. Black-Schaffer
You really need to have a professional organization with staff who have expertise in these areas, working with the actual practitioners, in our case, pathologists who are actually experiencing these challenges, to actually work out with the government in this instance an appropriate way to go forward.
Nick Lanyi
The CAP urged Congress to reject a White House proposal that would add significant new rules to federally funded research. Specifically, the President's Office of Management and Budget proposed to ban the use of federal funds for journal publication fees, though still requiring researchers to make their findings public. The CAP joined more than 160 medical and science organizations in a letter to Congress opposing the publishing restrictions. The organizations warned that the regulations could undermine research integrity, U.S. competitiveness, and independent scientific inquiry. The CAP is also reviewing other elements of the OMB proposal and will keep you posted on any further comments or advocacy efforts. CAP member Dr. Terri Yarbrough Green is the Democratic nominee for the U.S. House of Representatives in Arkansas's first congressional district. A native of Texas, Dr. Green moved to Arkansas in 1988 and has worked in hospitals and clinical laboratories throughout her career. She retired last year from Arkansas Methodist Medical Center in Parigould, Arkansas. She told us she decided to run for Congress in part because of her concerns about science funding.
Dr. Terri Green
I have been outraged, devastated, just hated watching the funding decreases, the slashing of funding for science and research. We are losing information and people that we are going to dearly, deeply regret losing them at some point in the future. We needed every bit of that research. We needed all of those people.
Nick Lanyi
She said she's also concerned about immigration policies making it harder for foreign medical professionals to practice in the U.S.
Dr. Terri Green
We have a shortage of pathologists, a shortage of doctors in all specialties. And so many of the doctors that we depend upon come from other countries.
Nick Lanyi
Dr. Green said campaigning has been a big adjustment from a life in the lab.
Dr. Terri Green
That has been a huge stretch for me. I've had to learn completely new skills. I've always considered myself an introvert and been happy behind a microscope. In one of my speeches recently I said I'm still much more comfortable behind a microscope than a microphone.
Nick Lanyi
But she also thinks her medical background would be a plus on Capitol Hill.
Dr. Terri Green
There are many healthcare issues, healthcare-related issues and legislation to be considered. And I think a scientific background is essential to understanding some of that legislation and a background as a medical professional is going to be essential in crafting healthcare legislation.
Nick Lanyi
And finally… the CAP is almost ready to reveal the new and improved cap.org. The refreshed website goes live this weekend with a cleaner look and feel, easier navigation, and faster responses. All the content you normally see will remain, but it should be simpler and quicker to find. And you'll see some new features as well. It's the biggest modernization of the website in a decade. Hope you enjoy the improvements. See the show notes for more information on today's stories. And if you've got a story you think we should cover, write to us at stories at cap.org. I'm Nick Lanyi. Have a wonderful weekend.