RESULTS Act

The RESULTS Act (S 2761) changes how Medicare sets payment rates for clinical diagnostic laboratory tests by requiring the collection of final payment data from private payors through a qualifying comprehensive claims database. For widely available non-ADLT tests (non-Advanced Diagnostic Laboratory Tests), this new system will apply to data collection periods beginning January 1, 2027, with reporting for these periods starting January 1, 2028. If data isn't available for a test, the bill establishes a default payment rate equal to the previous year's rate adjusted for inflation. This affects Medicare, clinical laboratories, and private payors by creating more accurate, market-based payment rates that better reflect final payments made by private insurers.