FEDERAL AGENCY NEWS
Bureau of Labor Statistics – Standard Occupational Classification Update
The NACNS is actively seeking an adjustment of the classification of Clinical Nurse Specialists (CNS) to the U.S. Department of Labor’s(DOL) Standard Occupational Classification (SOC). The SOC is managed by the Bureau of Labor Statistics (BLS) within the DOL. This effort will require outreach by every CNS program, student, and practicing CNS. In the coming weeks and months NACNS will provide guidance on how you can get involved.
The SOC matters enormously for CNSs because of a data invisibility problem: of the four APRN roles, nurse practitioners (29-1171), CRNAs (29-1151), and nurse midwives (29-1161) each received their own detailed SOC codes in the 2018 revision — but clinical nurse specialists did not. CNSs remain folded into the general “Registered Nurses” code (29-1141), making them statistically indistinguishable from staff RNs.
Why that matters:
- No workforce data. Without a distinct code, BLS, HRSA, and Census cannot count CNSs, track supply, wages, or shortages — which undercuts everything from HRSA workforce projections to shortage-based funding arguments. NACNS has argued that lumping CNSs with RNs makes the classification invalid for both groups and degrades the quality of healthcare workforce data.
- Policy leverage. Federal recognition in the SOC is foundational for downstream advocacy — Medicare/Medicaid recognition, Title VIII funding justifications, state scope-of-practice arguments, and employer job classification all lean on federal data that currently cannot see CNSs.
- Professional identity. NACNS contends that treating “Clinical Nurse Specialist” as just an RN title conflicts with how federal agencies, state practice acts, and the broader healthcare community distinguish CNSs — who have separate licensure, certification, graduate-level education, and in many states prescriptive authority.
On June 12, 2024, the Office of Management and Budget (OMB), which oversees the SOC classification system, announced a formal review of the 2018 SOC Manual. The review, which opened the first public comment period, closed on August 12, 2024. Following the closure of the first notice, the SOC Policy Committee (SOCPC) has been reviewing the public input that was received. Once finished, SOCPC will share its recommendations with the OMB. From there, the process will move to a second Federal Register, which will then share the proposed recommendations and allow for additional public comments. A third and final notice is tentatively scheduled for announcement in 2027. Currently, however, for anything after the first Federal Register, there is no set schedule, just a tentative implementation of the 2028 SOC at the beginning of the reference year.
To address this the NACNS sent a formal request to the BLS Commissioner seeking a change in classification in July of 2025. As we await a second notice for comment on the updated SOC, NACNS again is mounting a campaign to highlight the need for this important change. By assembling and documenting data and evidence, engaging stakeholders, and Members of Congress we aim to achieve the needed change in the SOC for CNSs. Please stayed tuned for how you can help NACNS with its advocacy efforts.
Department of Education Final Rule on Student Loans & Recent Court Actions
In reaction to the U.S. Department of Education’s final rule (the Reimagining and Improving Student Education (RISE), several lawsuits were filed by nursing organization. They seek to overturn the final rule which would implement student loan provisions enacted in July 2025 by the Congress through the One Big Beautiful Act (H.R.1). The law eliminates the Grad PLUS loan program and capped “graduate degree” and “professional degree” borrowing.
On June 25th, Judge Beryl Howell (D.D.C.) issued a preliminary injunction in the consolidated American Association of Nurse Practitioners v. McMahon / PA Education Association v. Department of Education cases, staying ED’s narrowed definition nationwide. Her core holding: when Congress adopted the preexisting regulatory definition “as in effect on July 4, 2025,” it codified that definition and removed the Department’s authority to narrow it.
Th practical effect is that the 11-field exclusive list of “professional degrees” and ED’s added criteria (doctoral-level, CIP codes, 6-year minimum) are blocked. It does not halt the broader student loan changes enacted by Congress which took effect July 1, and ED must now apply the older, broader 2007 regulatory definition to determine which programs qualify as “professional.”
Without the injunction, MSN and DNP degrees – including the CNS track – would have been reclassified into the lower “graduate” tier for loan categorization starting July 1st: $20,500/year, with a $100,000 lifetime cap. For now, however, nursing programs are evaluated under the “professional degree” definition of the pre-existing 2007 HEA, allowing them to stay in the higher tier: $50,000/year, $200,000 lifetime.
Congress has not acted yet, but an amendment added to the House Appropriations Committee’s FY27 Labor/HHS bill on June 9th would statutorily lock in advanced nursing programs (explicitly naming CNS) as professional degrees, which would end the uncertainty regardless of litigation outcome. However, it is unclear whether Congress will be able to enact this bill.
Further action in the courts is expected, and we will keep NACNS members updated on developments.
CAPITOL HILL NEWS
House Appropriations Committee Supports Funding of Health Professional Education
On June 25, 2026, the House Energy & Commerce Health Subcommittee advanced a broad, bipartisan package of health care bills focused on price transparency and prior authorization reform — several provisions carry direct relevance for clinical nurse specialists and the patients they serve.
Price Transparency
The Lower Costs, More Transparency Act of 2026 (H.R. 9393), led by Chair Brett Guthrie (R-KY) and Ranking Member Frank Pallone (D-NJ), would expand federal price disclosure requirements for hospitals, health plans, ambulatory surgical centers, labs, and imaging providers, and would strengthen regulatory enforcement tools.
Prior Authorization Reform
Two bills target administrative burdens that affect clinical workflow and patient care:
- Prior Authorization Accountability Act (H.R. 9396) — would require commercial insurers to publicly report approval/denial rates, appeal outcomes, response times, and their use of AI in prior authorization decisions.
- Improving Seniors’ Timely Access to Care Act (H.R. 3514) — the longstanding Kelly (R-PA)/DelBene (D-WA) bill requiring Medicare Advantage plans to adopt electronic prior authorization systems and meet new beneficiary protection and reporting standards.
Medicare Advantage Oversight
Additional measures would increase transparency around MA supplemental benefits, broker compensation, premium spending, and encounter-level cost data.
Community Health & Behavioral Health
Two community health center bills would expand behavioral health services and establish a nutrition education initiative.
Substance Use/Overdose Response
The subcommittee advanced five overdose-related bills, including measures to permanently schedule xylazine and nitazenes under the Controlled Substances Act, expand school access to overdose reversal drugs, support first-responder fentanyl/xylazine test strip training, and direct HHS to issue guidance on ED fentanyl testing protocols.
