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Congress·In Committee·6 months ago

Senate Committee Reviews RESULTS Act to Fix Medicare Lab Test Pricing Data

Also known as: RESULTS Act

Legislative Progress

✓ Filed
Review
Senate
House
President

Impacts

Positive Impacts(4)
Medicare
Helps
Chronic Illness
Helps
Housing Assistance
Helps
Disability Benefits
Helps

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.
Medicare MedicaidHealthcareConsumer Protection

Milestones

2 milestones2 actions
Sep 10, 2025Senate

Read twice and referred to the Committee on Finance.

Sep 10, 2025

Introduced in Senate

What Happens Next

Projected impacts based on AI analysis

Soon after the bill becomes law

Medicare starts working to pick and contract with an independent nonprofit claims-data organization

This sets up the new system that will later be used to help set prices for many common lab tests, instead of relying mainly on labs to report private-insurance payment data.

As new or updated rates are published after the new system begins

Medicare must publish a public explanation of each lab test payment rate (with supporting data as needed)

Labs (and the public) could better understand why a test pays what it pays, and spot potential calculation errors more easily.

Related News

4 articles
Physicians Practice·about 1 month ago

RESULTS Act aims to avert Medicare lab fee cuts that could hit physician office testing

The RESULTS Act would change how Medicare sets rates on the Clinical Laboratory Fee Schedule by revising how private payer data is used. It aims to improve the accuracy of data collection by relying on independent claims databases rather than just lab-reported figures to set payment levels.

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Dark Daily·7 days ago

ACLA Eyes RESULTS Act Vote at the End of the Year

The RESULTS Act calls for PAMA reform by permanently capping reimbursement cuts to 5% annually and identifying an independent claims database to help the federal government set Medicare rates for lab test claims, moving away from the criticized lab-based reporting approach.

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360Dx·6 months ago

Congress Introduces New Legislation to Reform Protecting Access to Medicare Act

The Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act aims to reform the PAMA rate-setting process by using a third-party database of private payor claims to establish Medicare payment rates, ensuring data is representative of the entire laboratory market.

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Source Information

Document Type

Congressional Bill

Official Title

RESULTS Act

Bill NumberS 2761
Congress119th Congress
ChamberSenate
Latest ActionRead twice and referred to the Committee on Finance.

Sponsor

Cosponsors

(8)
D: 4R: 4

Analysis generated by AI. While we strive for accuracy, this should not be considered legal or professional advice. Always verify information with official government sources.