The American College of Cardiology’s advocacy team has spent the first half of 2026 engaged on multiple fronts simultaneously — federal payment battles, state-level prior authorization campaigns and the rollout of a new heart failure payment model — with mixed results, according to a June 25 update.
Here’s where six major efforts stand now:
1. Telehealth flexibilities extended through 2027
Congress extended Medicare telehealth flexibilities through Dec. 31, 2027 in February 2026, one of the cleaner wins of the year for cardiology practices that had built their care models around virtual access. Lawmakers also reinstated virtual in-home cardiac and pulmonary rehabilitation services through Jan. 1, 2028. Both extensions had been lobbying priorities for the ACC going into the year.
2. Medicare’s –2.5% efficiency adjustment took effect
Despite meetings with more than 50 congressional offices, grassroots alerts and engagement with bipartisan physician caucuses, the ACC was unable to stop a –2.5% efficiency adjustment in the Medicare Physician Fee Schedule from going into effect this year. Long-term structural reform — including inflation-based payment updates and budget neutrality changes — remains the college’s top federal payment priority for the second half of 2026.
3. Prior authorization reform is the most active state-level battleground
State chapters have notched meaningful wins in 2026. Kentucky enacted comprehensive prior authorization reform. New York included prior authorization reform in the state budget. Pennsylvania passed its Smart Heart bill after a three-year campaign. Virginia enacted a new law banning non-compete agreements for healthcare professionals. New York and Vermont also secured funding for automated external defibrillators.
4. Preventive care coverage is the next state-level push
Several chapters are laying the groundwork for future wins on preventive cardiovascular coverage. In Illinois, members are pushing to require insurance coverage for coronary artery calcium testing. Rhode Island members are championing coverage for self-measured blood pressure monitoring. New York members introduced legislation targeting peripheral artery disease screening. Alaska has advanced CPR education legislation that is expected to be signed into law.
5. The new heart failure payment model is generating friction with CMS
As the Ambulatory Specialty Model for Heart Failure nears implementation, the ACC has communicated member concerns directly to the Centers for Medicare and Medicaid Services. Chief among them: issues related to specialty classification and limited transparency around heart failure cost data. The college, working alongside ACC chapters and MedAxiom, has been preparing selected participants, their practices and health system leaders with tailored resources and education ahead of the model’s launch.
6. Workforce and AI policy are on the federal docket
The ACC has weighed in on federal workforce issues including student loan burden and physician visa barriers, urging reconsideration of policies affecting advanced nursing programs, supporting zero-interest loan deferment during training, and pushing for physician exemptions from new H-1B visa application fees. On the technology side, the college has responded to multiple requests for information from federal agencies on AI, digital health tools and clinical research, and contributed input on CMS’s reconsideration of national coverage for transcatheter aortic valve replacement.
The ACC’s Legislative Conference is scheduled for Oct. 4-6 in Washington, D.C.
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