Quest Diagnostics, Labcorp and the laboratory trade groups spent the week pressing Congress on H.R. 5269, the RESULTS Act, after CMS posted preliminary 2027 Clinical Laboratory Fee Schedule rates. The schedule cuts 775 test codes by the statutory maximum of 15 percent and reduces payment on close to 1,200 codes in all. CMS puts the savings at about $1 billion a year.
The bill, paired with S. 2761 in the Senate, carries more than 130 cosponsors. It would require CMS to collect commercial claims data from a representative sample of laboratories instead of the current reporting pool, cut the reporting burden, and hold down the size of later reductions.
The American Clinical Laboratory Association's objection is about who reported. By its count, 2 percent of Medicare Part B laboratories submitted 2024 data. One percent of physician office labs did. Fewer than 20 percent of hospital outreach labs did. More than 4,000 independent laboratories reported nothing. CMS sets the rate off that sample.
For a diagnostics startup this is the number that decides whether a cleared assay has a business behind it. A CPT code priced off a thin sample does not care how good the analytical validation was. The House is out until after the November midterms, which leaves little room before the 2027 rates are finalized.