The legislation aims to reform the Medicare Clinical Laboratory Fee Schedule and prevent scheduled payment reductions starting in 2027.
The Problem Solvers Caucus announced its endorsement of the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act (HR 5269), a bipartisan bill designed to modernize the Medicare Clinical Laboratory Fee Schedule and maintain access to diagnostic testing for Medicare beneficiaries.
The Medicare Clinical Laboratory Fee Schedule is the system used to establish the cost of laboratory tests for Medicare beneficiaries. These services inform approximately 70% of clinical decisions. Without congressional action, payment rates for hundreds of routine laboratory tests are scheduled to face reductions beginning in 2027, which may create uncertainty for patients and limit access to diagnostic services in rural communities.
Provisions of the RESULTS Act
The RESULTS Act seeks to reform the Protecting Access to Medicare Act by improving the data used to set rates on the Clinical Laboratory Fee Schedule. The legislation is intended to support patient access to clinical laboratory services, reduce the administrative burden of data collection for laboratories and the Centers for Medicare and Medicaid Services, and provide stability to the Clinical Laboratory Fee Schedule through improved rate setting.
The bill is led by representative Richard Hudson (NC-09) and includes 106 additional cosponsors.
“Nearly every course of care begins with a laboratory result. It is the answer that can catch disease early, guide the right treatment, and give patients precious time,” says representative Brian Fitzpatrick (PA-01), Problem Solvers Caucus co-chair, in a release. “The RESULTS Act delivers the lasting reform patients and providers deserve—protecting access, preventing destabilizing cuts, and creating a fair, sustainable framework for the laboratories our health system relies on.”
Industry Support for Reform
The American Clinical Laboratory Association (ACLA) expressed support for the endorsement, noting the importance of data-driven reforms to the payment system.
“Their endorsement of the RESULTS Act underscores the growing bipartisan recognition that Medicare’s clinical laboratory payment system should be strengthened through thoughtful, data-driven reforms that protect access to laboratory testing services patients rely on at every step of their health care journey,” says Susan Van Meter, president of the ACLA, in a release.
Diagnostic developers also highlighted the role of laboratory infrastructure in patient care.
“As a developer of innovative diagnostic testing, we know that a strong, sustainable laboratory infrastructure is critical to patient care,” says Ami Simunovich, global head of quality, regulatory and external affairs at Roche Diagnostics, in a release.
Patient advocacy groups noted that access to testing is vital for the six in 10 Americans living with at least one chronic disease.
“By endorsing the RESULTS Act, the Problem Solvers Caucus is supporting a sustainable solution that would protect access to the clinical laboratory testing patients rely on,” says Liz Helms, CEO of the Chronic Care Policy Alliance, in a release.
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