Bipartisan Legislation Introduced to Protect Seniors' Access to Laboratory Services

Strategic Insights -

Representatives Scott Peters, Richard Hudson, and others have introduced the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act, aiming to protect seniors' access to essential laboratory services threatened by Medicare Clinical Laboratory Fee Schedule cuts. Without reform, deep cuts under the payment system are set to begin in January 2026, potentially restricting access to common lab tests for America's seniors.

Key Takeaways:

  • The RESULTS Act addresses the flawed data collection and reporting methods in the Medicare Clinical Laboratory Fee Schedule, which would lead to payment cuts for approximately 800 tests, including routine bloodwork, cancer screenings, and tests to manage heart disease and diabetes.
  • The legislation ensures a Medicare Clinical Laboratory Fee Schedule rate-setting process that is accurate and representative of commercial market rates for independent, physician-office, and hospital outreach laboratories.
  • The bill reduces the administrative data collection and reporting burden on clinical laboratories and lessens the administrative burden on the Centers for Medicare and Medicaid Services (CMS) while preventing destabilizing payment cuts.
  • Promotes diagnostic innovation by providing stability in Medicare reimbursement for laboratories to develop and deliver cutting-edge tests for cancer, heart disease, diabetes, metabolic disorders, and emerging public health threats.
  • Average yearly American seniors rely on laboratory tests for medical diagnosis and treatment; these include routine bloodwork, cancer screenings, and tests to manage heart disease and diabetes.
  • The RESULTS Act aims to ensure American seniors receive proper, accurate results for the medical tests necessary for ongoing health and well-being.
  • The legislation fosters cooperation between various stakeholders and policy makers ensuring senior citizens can continue to access critical lab tests necessary for their ongoing well-being.
  • The RESULTS Act is supported by multiple organizations and stakeholders representing millions of patients and providers, including the American Clinical Laboratory Association and the National Independent Laboratory Association.

Statistics:

  • Approximately 800 lab tests, including routine blood work, cancer screenings, and tests for heart disease, diabetes, and genetic disorders, will be subject to cuts of up to 15 percent in 2026.
  • Current and proposed cuts will impact millions of people with ongoing health conditions, potentially harming patient access to affordable healthcare options.
  • Without action, the 2026 cuts will add to previous reductions of up to 10 percent in 2018, creating instability in the healthcare system for millions of seniors.
  • Patient advocates and the laboratory community emphasize the importance of solid, long-term solutions like the one promised by the RESULTS Act.

Sources:

  • "U.S. Senator Thom Tillis." Remarks on the RESULTS Act, September 2023.
  • "National Institute for Biotechnology Information." A to Z of Lab Tests.
  • Congressional Hearing of the Senate Committee on Health, Education, Labor, and Pensions, "The State of the Clinical Laboratory Profession," March 2023.
  • Susan Van Meter, American Clinical Laboratory Association President. Press Release on the RESULTS Act, September 2023.
  • American Clinical Laboratory Association. The State of Clinical Laboratories in the United States, March 2023.
  • National Independent Laboratory Association. Press Release on the RESULTS Act, September 2023.