RESULTS Act

Key Points

• Congress would change how Medicare sets prices for many common lab tests, aiming to keep patient access stable.
• Starting with data collected in 2027 and used for payments in later years, Medicare would rely more on “final” private insurance payment amounts, not preliminary or disputed ones.
• For widely used lab tests, Medicare would get pricing data from a large, independent nonprofit claims database, instead of mainly relying on labs to report prices.
• If Medicare can’t get the database data for a common test, payments would generally roll forward with an inflation update instead of dropping due to missing data.
• The bill also requires Medicare to publicly explain how it calculated each lab test’s payment rate, so labs can check for errors.