Laboratory reimbursement rates under Medicare have precipitously declined as a result of the flawed implementation of the Protecting Access to Medicare Act (PAMA). Fair reimbursement is essential to prevent labs from eliminating tests, laying off employees, and reducing services for patients who rely on quality testing.

Congress intended for PAMA to modernize the clinical laboratory fee schedule to more closely align lab reimbursement rates with private payers. However, the data reporting process used by the Centers for Medicare and Medicaid Services (CMS) does not accurately represent real-world prices. Payment information disproportionally collected from large commercial laboratories that benefit from economies of scale has resulted in drastic payment cuts that threaten the ability of many laboratories, particularly in underserved areas, to provide essential services. 

ADLM urges you to contact your legislators and request that they support the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services  (RESULTS) Act, which would reform the private payer reporting requirements, and implement a payment methodology that ensures labs receive fairer reimbursement for the critical services they provide.