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US SB2761
Bill
AI Summary
- Amends Medicare payment rates for clinical diagnostic laboratory tests by requiring data collection from a qualifying independent nonprofit entity's comprehensive claims database containing at least 50 billion claims from 50+ private payors, beginning January 1, 2028
- Creates two categories of lab tests: "widely available" tests (performed by more than 100 providers) will have rates set using the independent database, while less common tests and advanced diagnostic tests will continue using direct laboratory reporting
- Extends current data reporting deadlines by two years (from 2025 to 2027) and changes data collection periods from 3 years to 4 years, with reporting windows shifted from January-March 2026 to January-March 2028
- Caps annual Medicare payment reductions at 5% for 2029 and beyond (previously 15% for 2026-2028) and requires payment rates to reflect only final payments, excluding denied claims, appeals, errors, and recoupments
- Requires the Secretary to publicly explain payment rate calculations and sunsets limitations on administrative and judicial review of payment determinations for claims filed after January 1, 2029
Legislative Description
RESULTS Act Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act of 2025
Health
Last Action
Read twice and referred to the Committee on Finance.
9/10/2025
Committee Referrals
Finance9/10/2025
Full Bill Text
No bill text available