Ongoing discussions continue around how Medicare sets payment rates for laboratory services.
What’s happening: Policy discussions include proposals such as the RESULTS Act, which aims to stabilize the Clinical Laboratory Fee Schedule (CLFS) and address ongoing concerns with the Protecting Access to Medicare Act (PAMA).
What’s being discussed:
- Long-term reforms to reduce volatility in Medicare lab payments.
- The RESULTS Act, which would limit payment decreases to five percent per year once fully implemented.
- Current policies, which allow payment cuts of up to 15 percent annually over the next three years, with no cap after that.
- Potential short-term steps to prevent steep cuts if broader reforms don’t advance.
What to watch: Discussions are ongoing around both short-term options to mitigate potential cuts and longer-term changes to how lab payment rates are set.
Our view: The CAP continues to advocate for policies that provide greater stability in Medicare laboratory payment while protecting access to care.