The Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act (H.R. 5269/S.2761) was introduced by bipartisan coalitions in the U.S. House of Representatives and Senate on Sept. 11 to address cuts to the Medicare Clinical Laboratory Fee Schedule, set to begin in January as part of the Protecting Patient Access to Medicare Act (PAMA).
According to the American Clinical Laboratory Association, PAMA was meant to establish market-based rates for clinical laboratory services paid under the CLFS, but because rates were based on data collected from less than 1 percent of all laboratories, payments have been low and nearly $4 billion has been cut from the CLFS in three years.
Without congressional action, reimbursement for about 800 routine blood tests, cancer screenings, and tests to manage heart disease and diabetes will be reduced by 15 percent starting Jan. 1, according to a press release from the office of Rep. Scott Peters (D-Calif.), one of the bill’s sponsors.
The RESULTS Act would ensure a CLFS rate-setting process that is representative of commercial market rates for laboratories using information from an independent not-for-profit commercial claims database for widely available tests and using information on private payer rates for less ubiquitous tests. Other key provisions include:
- Reducing administrative burden from PAMA data collection and reporting requirements.
- Relief from the fourth round of Medicare rate cuts.
- Stabilizing Medicare reimbursement for laboratories to develop and deliver innovative new tests.
“As our industry continues to innovate and tailor health care solutions through personalized medicine, the RESULTS Act is a critical step to safeguard access to these life-saving tools, reinforce our health care infrastructure, and support continued innovation in laboratory medicine,” ACLA President Susan Van Meter said in a statement.
The RESULTS Act is an alternative bill to the Saving Access to Laboratory Services Act, which amassed widespread support but was not ultimately passed in the previous Congress.
Both versions of the bill were referred to relevant committees for further consideration.
Sources:
https://www.acla.com/wp-content/uploads/2025/09/The-RESULTS-Act-Overview_Sept-2025-1.pdf
