Witnesses urge Congress to pass Results Act to avert Medicare lab cuts
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Summary
Clinical laboratory leaders told the House Energy and Commerce health subcommittee that outdated data under PAMA threatens steep Medicare cuts to routine tests on Jan. 31 and urged the Results Act to provide representative private‑payer data, guardrails against deep reductions and relief from reporting burdens.
Susan Van Meter, president of the American Clinical Laboratory Association, told the House Energy and Commerce Subcommittee on Health that Medicare’s clinical laboratory fee schedule is based on incomplete, outdated data and risks sharp cuts to routine testing if Congress does not act.
“We are now 23 days away from Medicare cuts to about 800 tests of as much as 15% hitting laboratories across the country,” Van Meter said in opening testimony, warning that reductions will fall disproportionately on tests smaller, rural labs rely upon. She said PAMA’s data-collection process undercuts accuracy because fewer than 1% of laboratories reported private‑payer data the last time CMS collected information.
The Results Act (HR 5269), sponsored in the House as part of today’s slate, would require CMS to contract with an independent claims database to obtain representative commercial market data for setting CLFS rates, Van Meter said, pointing to the Fair Health database as an example of an entity with broad claims coverage. She described three core problems with current law: incomplete commercial data, reductions larger than Congress intended, and excessive administrative reporting burdens.
Committee members pressed witnesses for specifics. Chair Guthrie noted the example of a complete blood count test currently reimbursed at $7.77 and asked what an 11% cut would mean for access in rural areas. Van Meter said such cuts could force smaller providers to curtail menus, lengthen turnaround times or close, reducing access to routine diagnostics used in everyday care.
Patient advocates and legal experts at the hearing emphasized related concerns about Medicare Advantage and prior-authorization practices that can delay care, but their testimony reinforced the point that stable payment policy is critical for maintaining diagnostic capacity and innovation. David Lipschutz of the Center for Medicare Advocacy testified separately in support of more transparency for supplemental benefits and protections against AI‑driven denial programs.
The subcommittee’s questions centered on implementation details: how an independent database would supply representative rates, whether using Fair Health would meet statistical needs, and how to limit administrative burden on small labs. Van Meter argued the Results Act would reduce reporting requirements while providing CMS access to claims-level volumes and rates that reflect physician office, hospital outreach and independent laboratories.
If the Results Act or a similar fix is not enacted, witnesses warned that scheduled reductions could take effect, threatening service availability in rural and underserved communities and undermining investments in diagnostics. The committee concluded the questioning phase and invited written follow‑up; no formal vote occurred at the hearing.
