RESULTS Act

This bill changes how Medicare sets payment rates for clinical diagnostic lab tests, which are based on what private insurers pay. Starting with reporting periods in 2028, Medicare would get private insurer payment data for widely used lab tests from a national nonprofit claims database under contract, instead of relying only on reports from labs. It delays the next lab data reporting period to January through March 2028 and defines "final payment rate" to exclude denied, appealed, erroneous, or recouped payments. It limits yearly payment cuts for these tests to 5 percent starting in 2029 and requires Medicare to publicly explain each test's payment rate. If no contract or data is available, payments for widely used tests would rise each year with consumer prices.

Full text and official record on Congress.gov

Sponsors

• Thom Tillis Republican sponsor
• 13 cosponsors