RESULTS Act

Improved Access to Tests: The bill seeks to "provide long-term stability for Medicare beneficiary access to clinical diagnostic laboratory tests" by improving the accuracy of payment rates (Section 2).

More Accurate Payment Rates: By requiring the Secretary to use a "qualifying comprehensive claims database" from an "independent national nonprofit entity," the bill aims to improve the accuracy of the private payor-based fee schedule (Section 2(a)(1)(A)(ii)).

Protection Against Payment Gaps: For "widely available non-ADLT clinical diagnostic laboratory tests," the bill provides a default payment that is "equal to the amount of payment... for the previous year, increased by the percentage increase in the Consumer Price Index" if data is unavailable (Section 2(b)(2)(A)).

Increased Transparency: The Secretary is required to "make available to the public an explanation of the payment rate for such test," which includes supporting data so laboratories can check the accuracy of the math (Section 2(b)(4)).

Potential for Unreliable Data Application: The bill relies on the Secretary entering into a contract with a "qualifying independent claims data entity" to report information; if the Secretary is unable to enter such a contract, a default payment process is triggered instead (Section 2(b)(2)(A)(ii)).

Limited Scope for Certain Tests: The specific data collection and default payment improvements apply to "widely available non-ADLT clinical diagnostic laboratory tests," which are defined as tests where the number of providers exceeds 100 (Section 2(a)(2)(E)).