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Stabilizing Medicare Payments for Clinical Diagnostic Laboratory Tests

This bill modifies how Medicare pays for widely available clinical diagnostic laboratory tests to ensure their continued availability for beneficiaries. It introduces payment calculation methods based on statistical sampling of market data, aiming to reduce administrative burdens for laboratories. The legislation seeks financial stabilization by limiting sudden fluctuations in payment rates for diagnostic services.
Key points
Medicare payments for widely available lab tests will be established using a statistically valid sample of laboratories, rather than requiring data reporting from every applicable laboratory.
The frequency of data reporting by laboratories is changed from every three years to every four years, with the next reporting period delayed until 2027.
The bill introduces annual percentage caps on both reductions and increases in payment rates for clinical diagnostic laboratory tests.
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Additional Information
Print number: 118_S_1000
Sponsor: Sen. Brown, Sherrod [D-OH]
Process start date: 2023-03-28