Results act
Results Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
The Results Act, also known as the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act of 2025, aims to improve the accuracy and feasibility of data collection for Medicare payment rates for widely available laboratory tests. Specifically, it requires the Centers for Medicare & Medicaid Services (CMS) to contract with a qualified, independent, and nonprofit entity to obtain data from a comprehensive claims database. Starting in 2028, CMS must use this data to inform Medicare payment rates for these tests, while also delaying scheduled payment reductions and establishing a process for determining rates for less common tests. The bill also includes provisions for updating payment rates and ensuring market-based data.
Key provisions
- Requires CMS to contract with a qualified, independent, and nonprofit entity to maintain a database of claims data for widely available laboratory tests.
- Specifies data requirements for the database, including representation of the entire country and data from over 50 private payors.
- Sets a start date of January 1, 2028, for using the database to inform Medicare payment rates.
- Delays scheduled payment reductions for laboratory tests until 2028.
- Establishes a process for determining payment rates for laboratory tests that are not widely available.
- Includes provisions for updating data collection periods and ensuring data is market-based.
- Modifies payment reduction limits to apply to subsequent years.
- Requires CMS to provide a public explanation of payment rates.
Who is affected
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