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HR5269FEDERALin_committee

The RESULTS Act: Updating Medicare Lab Test Payment Rules

Original title: RESULTS Act

September 10, 2025

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Where This Stands

Introduced
Committee
Floor Vote
Passed
Signed

Currently in_committee. The next step in the legislative lifecycle is Floor Vote.

Last action
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.Sep 10, 2025

Version history

Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.

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The Frame

What this does

This bill changes the data collection process used to set Medicare reimbursement rates for common lab tests, which affects how much Medicare pays laboratories and potentially impacts the availability of these tests for Medicare beneficiaries.

Who is mentioned in the record

Potentially affected actors named in the source documents. Mention is not a position.

Clinical Diagnostic Laboratories

These entities will see changes to the data reporting requirements and the methodology used to determine their Medicare reimbursement rates.

Medicare Beneficiaries

These individuals may experience changes in the availability or access to diagnostic laboratory tests depending on how payment rate adjustments affect providers.

Department of Health and Human Services

The agency is tasked with contracting with an independent data entity and overseeing the new data collection process.

What changed

Current stage: in_committee.

What's next

Floor Vote.

Summary

The RESULTS Act proposes changes to how Medicare calculates payment rates for s. It shifts data collection methods for certain tests to a third-party nonprofit database starting in 2028 to improve accuracy and reduce reporting burdens on laboratories.

Key Facts

  • The bill is officially titled the 'Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act of 2025' or the 'RESULTS Act'.
  • Starting January 1, 2028, the Secretary of Health and Human Services must use data from a 'qualifying independent claims data entity' to set payment rates for widely available, non-advanced diagnostic laboratory tests.
  • The Secretary is required to contract with a national nonprofit organization to serve as the qualifying independent claims data entity.
  • The bill extends the data collection period for certain laboratory test reporting requirements from 2025 to 2027.
  • The reporting period for specific laboratory tests is adjusted to begin January 1, 2028, and end March 31, 2028.
  • The definition of 'applicable laboratory' for reporting purposes is updated for periods beginning on or after January 1, 2028.
  • Qualifying independent claims data entities must be national nonprofits, unaffiliated with health insurance or provider organizations, and compliant with HIPAA privacy laws.
  • Qualifying databases must undergo quality assurance processes, including comprehensive statistical testing.

Why It Matters

This bill changes the data collection process used to set Medicare reimbursement rates for common lab tests, which affects how much Medicare pays laboratories and potentially impacts the availability of these tests for Medicare beneficiaries.

Frequently Asked Questions

How will this change Medicare payments for lab tests?
Instead of relying solely on direct reporting from laboratories, the government will use data from an independent, nonprofit claims database to determine payment rates for common tests starting in 2028.
Who is considered a 'qualifying independent claims data entity'?
A national nonprofit organization that is not affiliated with health insurers, providers, or government agencies, and which maintains a database that meets specific privacy and quality assurance standards.

News Coverage

No news coverage found yet. Articles are indexed twice daily.

Lobbying Activity

NATURAL RESOURCE RESULTS LLC

on behalf of BONEFISH & TARPON TRUST

VENABLE LLP

on behalf of SUTTER HEALTH

Sponsors

Discoveries

Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.

policy shift90% confidence

Outsourcing Data Collection

The bill represents a shift from government-mandated direct reporting by labs to the use of third-party, nonprofit-managed claims databases for setting Medicare rates.

Connected Entities

organizationCommittee on Energy and CommerceCongressional committee assigned to review the bill.Map →
otherSocial Security ActThe primary law being amended by this bill.Map →
organizationCommittee on Ways and MeansCongressional committee assigned to review the bill.Map →
personMr. HudsonPrimary sponsor of the bill.Map →

Analysis Score

0–100
  • Significance65
    How much this matters to a regular citizen
  • Controversy20
    Intensity of disagreement among stakeholders
  • Entertainment5
    Compellingness for a non-policy-wonk reader
  • Buzz15
    Current news / social attention level

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