January 19, 2026
By Graham Melstrand, Government Relations Strategist, CREP/USREPS
In 2025, the Coalition for the Registration of Exercise Professionals (CREP) made a decisive shift: from simply tracking policy activity to actively shaping the policy environment that affects exercise professionals, public health, healthcare integration, and athlete safety.
This was not about chasing headlines or reacting to every bill introduced. It was about building the infrastructure, discipline, and credibility required to ensure that when policymakers talk about physical activity, exercise, safety, and prevention they understand who is qualified, what standards matter, and why it matters to the public.
Here’s what that looked like in practice, and why it positions CREP for meaningful influence in 2026 and beyond.
Building Policy Intelligence as Infrastructure
Throughout 2025, CREP maintained continuous monitoring of federal legislation and all 50 state legislatures. At peak activity, this meant tracking more than 130 bills per month touching issues relevant to the exercise profession, including:
- Professional recognition and scope of practice
- Education and credentialing standards
- Healthcare integration and reimbursement
- Public health and physical activity policy
- Athlete safety
- Labor, tax, and business regulations
Each bill was assessed through a structured lens: support, oppose, or watch, and further categorized by immediate, emerging, or long-term relevance.
Why this matters:
Policy monitoring isn’t busywork. When done well, it reduces risk, prevents surprises, and allows organizations to focus energy where it can actually change outcomes. In 2025, this discipline allowed CREP to prioritize high-impact opportunities rather than dilute its voice across low-value activity.
Strategic Advocacy, Not Symbolic Engagement
CREP’s advocacy in 2025 was intentionally selective. Letters of support and concern were deployed where CREP’s expertise added real value and where legislative momentum created an opportunity to influence outcomes.
Key federal efforts included engagement on:
In parallel, CREP maintained direct communication with state legislative offices and coordinated early with aligned organizations when interests overlapped—without compromising CREP’s independence or clarity of mission.
The result: CREP increasingly showed up as a solutions-oriented policy stakeholder, not a reactive trade association. That distinction matters to policymakers, and it compounds over time.
Athlete Safety: From Tragedy to Accountability
Athlete safety emerged as one of CREP’s most visible and consequential policy areas in 2025.
Across the country, preventable injuries, and deaths, particularly related to extreme heat, conditioning practices, and inadequate emergency preparedness continued to expose gaps in supervision, qualifications, and accountability.
CREP elevated athlete safety by:
- Treating it as a core policy priority, not an episodic issue
- Connecting legislative proposals to real-world outcomes
- Advocating for standards that emphasize qualifications and oversight
This approach contributed to multiple state-level policy wins aligned with CREP priorities and positioned the organization as willing to engage in hard but necessary conversations about responsibility in sport.
Athlete safety is no longer a side issue for CREP. It is a defining pillar of its policy identity.
Advancing Healthcare Integration Through the U.S. National Exercise Referral Framework
In 2025, CREP also advanced the U.S. National Exercise Referral Framework (U.S. NERF) as a practical tool for policymakers, healthcare leaders, and payers.
The NERF helps answer questions that policymakers consistently ask, but rarely get clear answers to:
- Which exercise professionals are qualified to receive referrals?
- Under what conditions and levels of medical oversight?
- How do credentials align with scope and risk?
By framing exercise as a structured, referable intervention, rather than a generic wellness concept, CREP shifted conversations toward coverage, workforce integration, and long-term reimbursement pathways.
This reframing is foundational. Without it, exercise remains an “amenity.” With it, exercise becomes infrastructure.
Transparency, Governance, and Member Alignment
Throughout the year, CREP ensured that policy work was not happening in a vacuum:
- Monthly board updates provided continuity and clarity
- Member town halls translated policy activity into operational relevance
- Blogs and advocacy content reinforced CREP’s leadership role
An October 2025 member survey confirmed strong alignment with CREP’s policy priorities and high satisfaction with the direction and execution of the work.
That feedback matters, not as validation, but as confirmation that CREP is investing in the right capabilities at the right time.
What Is Different Because of 2025
By the end of the year, CREP had fundamentally shifted its posture:
- From reactive monitoring to strategic policy intelligence
- From generalized advocacy to targeted, evidence-based engagement
- From participation to leadership
This work reduced exposure to scope-of-practice risk, increased credibility with policymakers, and created a durable foundation for future progress.
A Clear Focus for 2026
The systems and relationships built in 2025 allow CREP to play offense in 2026. Priority areas include:
- Advancing coverage and reimbursement conversations for outcomes-based exercise programs (e.g., cancer exercise, balance and fall prevention)
- Expanding athlete safety advocacy with a continued focus on qualifications and accountability
- Supporting HSA/FSA and workforce-aligned policy opportunities tied to credentialing and professional development
- Engaging proactively with a new Congress and evolving federal agencies
This is not about doing more. It’s about doing what matters deliberately, consistently, and with long-term impact in mind.
CREP enters 2026 positioned not just to respond to policy, but to help define it.
