Results act
Results Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Overview
The Results Act aims to improve the accuracy and feasibility of data collection for Medicare payment rates for clinical diagnostic laboratory tests. Specifically, it seeks to establish a more reliable system for determining these rates by utilizing data from independent, comprehensive claims databases. The bill also includes provisions to ensure that payment rates reflect actual payment amounts and to address potential gaps in data availability, particularly for non-widely available tests, and to update the data collection periods and methodology.
Key provisions
- Establishes a system for collecting data on clinical diagnostic laboratory test payment rates from independent claims databases.
- Requires the Secretary of Health and Human Services to contract with a qualifying independent claims data entity.
- Defines key terms, including ‘widely available non-ADLT clinical diagnostic laboratory test’ and ‘qualifying independent claims data entity.’
- Incorporates data collection improvements into private payor-based Medicare payment rates.
- Updates data collection periods to begin January 1, 2027.
- Modifies limitations on payment reductions to reflect future years.
- Requires the public availability of explanations of payment rates.
Who is affected
- Medicare beneficiaries
- Laboratory providers
- Private payors (insurance companies)
- The Centers for Medicare & Medicaid Services (CMS)
Bill text
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Sponsors
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Cosponsors
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