Advocacy - Lab Advocate
Reform of the Protecting Access to Medicare Act (PAMA) remains a central focus for the association. The current Clinical Laboratory Fee Schedule (CLFS) reporting framework established by the Centers for Medicare and Medicaid Services skewed reimbursement rates that fail to reflect the full laboratory market, disproportionately impacting hospital and community-based laboratories. Without structural reform, ongoing payment cuts threaten patient access to essential diagnostic services — particularly in rural and underserved communities.
Recent congressional action delayed the upcoming Medicare laboratory data reporting period and CLFS cuts, moving it to May 1–July 31, 2026, and requiring laboratories to report private-payor rate data from January 1–June 30, 2025 for use in setting payment rates beginning in 2027. While this delay provides additional preparation time and ensures more current market data are used, it does not resolve the underlying structural flaws in the reporting framework.
ADLM, in coordination with a broad coalition of laboratory stakeholders, continues to advocate for passage of the RESULTS Act, bipartisan legislation designed to modernize Medicare data collection and establish a more representative, sustainable reimbursement methodology.
In recent meetings with key congressional offices, ADLM has emphasized the need to:
Reforming PAMA remains one of the association’s top advocacy priorities. ADLM is committed to advancing solutions that protect patient access, strengthen the laboratory workforce, and ensure Medicare reimbursement accurately reflects the value of diagnostic testing.