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Medicare Lab Test Access Stability: New Payment Rules

This act aims to ensure long-term stability for Medicare beneficiaries' access to clinical diagnostic laboratory tests. It introduces changes in how market price data is collected and how payment rates are calculated to make them more accurate and reflective of actual costs. This means citizens using Medicare can expect more predictable and fair funding for essential laboratory tests.
Key points
Changes in lab test price data collection: Starting in 2028, data for widely available tests will come from an independent, national claims database, not just from laboratories.
Improved payment rate calculation: New methods are designed to ensure Medicare payment rates for lab tests better reflect market prices, potentially impacting laboratory financial stability and service availability.
Payment reduction limits: The act modifies limits on payment reductions for lab tests, introducing a 5% limit from 2029 onwards, aiming to protect laboratories from drastic revenue drops.
Transparency of payment rates: The Secretary will be required to publicly explain payment rates for tests, increasing transparency and allowing laboratories to assess calculation accuracy.
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Introduced
Citizen Poll
No votes cast
Additional Information
Print number: 119_HR_5269
Sponsor: Rep. Hudson, Richard [R-NC-9]
Process start date: 2025-09-10
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Summarized by: gemini-2.5-flash-preview-05-20
Source data: api.congress.gov
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OFFICIAL LEGAL TITLE

RESULTS Act

FREQUENTLY ASKED QUESTIONS

What is the official ID of this bill?

The official print number for this legislation is 119_HR_5269.

Which chamber initiated this legislation?

This legislation was initiated in the House of Representatives.

When did the legislative process begin?

The process officially started on 2025-09-10.

What are the main provisions?

Key points include:

  • Changes in lab test price data collection: Starting in 2028, data for widely available tests will come from an independent, national claims database, not just from laboratories.
  • Improved payment rate calculation: New methods are designed to ensure Medicare payment rates for lab tests better reflect market prices, potentially impacting laboratory financial stability and service availability.
  • Payment reduction limits: The act modifies limits on payment reductions for lab tests, introducing a 5% limit from 2029 onwards, aiming to protect laboratories from drastic revenue drops.
  • Transparency of payment rates: The Secretary will be required to publicly explain payment rates for tests, increasing transparency and allowing laboratories to assess calculation accuracy.
What is the specific legal status?

The current status is Introduced.

Where can I read the full text of this legislation?

The full official text is available at: View full text

Who is the primary sponsor?

The primary sponsor is Rep. Hudson, Richard [R-NC-9].

What is the latest detailed status?

The latest detailed status is: Introduced in House

Is this summary verified?

Yes. This content was analyzed by AI and verified by the Lustra Judge System on 2025-12-23.

CATEGORIES

Health