RESULTS Act

Hozzl · 2025-10-07T08:05:17Z

Explore the details of House Bill 5269 RESULTS Act currently in Congress. Get insights into its purpose, current status, sponsors, and potential impact on Health. Stay informed on legislative developments.

10/7/2025, 8:05 AM

Summary of Bill HR 5269

This bill, titled "To amend title XVIII of the Social Security Act to provide long-term stability for Medicare beneficiary access to clinical diagnostic laboratory tests," was introduced in the 119th Congress as H.R. 5269 on September 10, 2025. The bill aims to improve the accuracy of and feasibility of data collection for the private payor-based fee schedule payment rates applied under the Medicare program for such tests, in order to ensure long-term stability for Medicare beneficiaries' access to these tests.

Congressional Summary of HR 5269

Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act of 2025 or the RESULTS Act

This bill requires the use of particular data from the private sector to inform Medicare payment rates for certain widely available laboratory tests.

Specifically, the Centers for Medicare & Medicaid Services (CMS) must contract with an entity that maintains a database of claims data for clinical diagnostic laboratory tests that (1) are not advanced diagnostic tests, and (2) were furnished by more than 100 providers and suppliers of such services over a specified six-month period (i.e., widely available tests).

The database must meet specified requirements, such as having data that is representative of the entire country and from more than 50 private payors and claims administrators. The contracted entity must be a nonprofit entity that is not affiliated with any government agency, any insurance issuer or provider, or any other organization in the health care sector.

Beginning January 1, 2028, the CMS must use the information obtained from the database to inform Medicare payment rates for these widely available laboratory tests.

The bill additionally specifies processes for determining payment rates for laboratory tests that are not advanced diagnostic tests, are not widely available, and lack adequate claims data. The CMS must use certain existing processes to set appropriate rates.

The bill also delays scheduled payment reductions for laboratory tests until 2028 and allows for judicial and administrative review of payment rates.

Read the Full Bill

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Current Status of Bill HR 5269

Bill HR 5269 is currently in the status of Bill Introduced since September 10, 2025. Bill HR 5269 was introduced during Congress 119 and was introduced to the House on September 10, 2025. Bill HR 5269's most recent activity was 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. as of September 10, 2025

Bipartisan Support of Bill HR 5269

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Unaffiliated Sponsors

Total Number of Cosponsors

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Policy Area and Potential Impact of Bill HR 5269

Primary Policy Focus

Health

Alternate Title(s) of Bill HR 5269

To amend title XVIII of the Social Security Act to provide long-term stability for Medicare beneficiary access to clinical diagnostic laboratory tests by improving the accuracy of, and feasibility of data collection for, the private payor-based fee schedule payment rates applied under the Medicare program for such tests, and for other purposes.