ACLA Applauds Introduction of RESULTS Act to Safeguard Seniors’ Access to Critical Diagnostic Tests
Association relaunches ‘Stop Lab Cuts’ campaign to push for long-term Medicare payment reform
Washington, DC — The American Clinical Laboratory Association (ACLA) today welcomed the introduction of the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act, bipartisan, bicameral legislation that would protect seniors’ access to essential clinical laboratory tests by reforming the Medicare Clinical Laboratory Fee Schedule (CLFS) rate-setting process and mitigating steep Medicare payment cuts scheduled to resume next year.
The Protecting Access to Medicare Act (PAMA), passed in 2014, was meant to establish market-based rates for clinical laboratory services paid under the CLFS through collection of private payor rate data from independent, hospital outreach, and physician office laboratories. However, when PAMA was implemented, this goal was not achieved, as CLFS rates were set based on data collected from less than one percent of all laboratories, resulting in artificially low payment rates and cutting nearly $4 billion from the CLFS in just three years. Without congressional action, about 820 laboratory tests’ CLFS rates will be cut by up to 15 percent beginning January 1, 2026, threatening patient access to routine and life-saving diagnostics.
The RESULTS Act, led by U.S. Representatives Richard Hudson (R-NC), Gus Bilirakis (R-FL), Brian Fitzpatrick (R-PA), Raja Krishnamoorthi (D-IL), and Scott Peters (D-CA) in the House, and U.S. Senators Thom Tillis (R-NC) and Reverend Raphael Warnock (D-GA) in the Senate, would reform PAMA by dramatically improving the data used to set CLFS rates. The legislation also would reduce the administrative burden for laboratories and the Centers for Medicare and Medicaid Services (CMS), while providing long-term stability to the Medicare CLFS and mitigating future rate reductions, supporting and enhancing beneficiary access to innovative clinical laboratory services.
“Clinical laboratories deliver essential information that individuals need to better understand their own health status, while also serving as the backbone of our health care system, providing the results that inform 70 percent of medical decisions,” said ACLA President Susan Van Meter. “Both routine and advanced laboratory test results serve as the GPS for guiding patient care. As our industry continues to innovate and tailor health care solutions though 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.”
To determine CLFS rates for widely available tests, the legislation would direct the Centers for Medicare & Medicaid Services (CMS) to use an independent, not-for-profit commercial claims database with robust private payor claims data for all laboratory segments. For non-widely available tests, such as proprietary tests and those for rare diseases, clinical laboratories would report commercial data directly to CMS to set rates for these services. To determine CLFS rates for widely available tests, the legislation would direct CMS to use an independent, not-for-profit commercial claims database with robust private payor claims data for all laboratory segments. For non-widely available tests, such as proprietary tests and those for rare diseases, clinical laboratories would report commercial data directly to CMS to set rates for these services. The RESULTS Act would further reduce administrative burden by extending the rate-setting cycle to every four years (rather than every three years), establishing guardrails to protect laboratories from destabilizing annual payment cuts, and excluding artificially low Medicaid managed care payment rates from private payor data.
“ACLA is deeply grateful to Reps. Hudson, Bilirakis, Fitzpatrick, Krishnamoorthi, Peters, and Senators Tillis and Warnock for their leadership in advancing this urgently needed legislation and delivering permanent payment stability for the clinical laboratory community and the patients they serve,” Van Meter added.
Reps. Hudson, Bilirakis, Neal Dunn (R-FL), Fitzpatrick, and John Joyce (R-PA) recently also urged CMS to use its authorities under current law to mitigate pending reductions and improve data collection and reporting as Congress works to pass foundational PAMA reform legislation later this year.
ACLA has also re-launched the ‘Stop Lab Cuts’ advocacy campaign, which has garnered support from individuals across the country who want to protect access to innovative clinical laboratory testing services. The campaign serves as a central advocacy hub and resource for information on the need for long-term payment reform. Visit StopLabCuts.org to learn more.
ACLA looks forward to working with Congress to advance this urgently needed legislation and deliver permanent payment stability for the clinical laboratory community and the patients they serve.
- This press release was originally published by ACLA