Medicare reimbursement remained a major focus of ADLM’s advocacy as laboratories prepared for the first new Protecting Access to Medicare Act data reporting cycle in years. Congress delayed scheduled Clinical Laboratory Fee Schedule reductions through 2026 and revised the reporting timeline, but the underlying PAMA payment structure remains unchanged.
The 2026 reporting period ended July 31. Applicable laboratories reported private payor data collected from January 1 through June 30, 2025, which CMS will use to establish Clinical Laboratory Fee Schedule rates beginning in 2027. Under current law, payment reductions may resume in 2027 at up to 15% per year through 2029.
ADLM continued supporting the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act, or RESULTS Act, H.R. 5269/S. 2761. In April, ADLM joined laboratory, patient, provider, and diagnostics stakeholders in meetings with congressional offices to urge support for the legislation. The RESULTS Act would change how Medicare collects market data, reduce reporting burden, provide greater payment stability, and hold Clinical Laboratory Fee Schedule rates at current levels through 2028 while a new reporting system is implemented.
With the 2026 reporting cycle now complete, ADLM continues to emphasize that temporary delays alone do not resolve PAMA’s structural problems and that permanent reform is needed to protect patient access to laboratory testing.