The National Advisory Committee on Institutional Quality and Integrity (NACIQI) voted against renewing recognition of the Council on Naturopathic Medical Education, sending the matter to the Department of Education for a final decision. NACIQI voted 12–0, citing concerns about student outcomes and faulting the accreditor for relying on student demographics rather than quality benchmarks. NACIQI’s motion also raised financial concerns about the accreditor and included testimony from speakers who argued CNME member institutions saddle students with heavy debt and limit career prospects. CNME officials defended their program rigor and noted that debt concerns are systemic across health-care education. Until the Department of Education rules, CNME’s recognition status remains in flux, creating compliance uncertainty for affected institutions and their students.