Loading…
H.R. 5269119th CongressIn committeeLatest action Sep 10, 2025Decoded by AI · checked against the record
The plain-language version leads. The official text is always the reference.
Starting in 2028, Medicare would pull lab test pricing from an independent database instead of requiring labs to report it themselves.
40-second read · 4 questions answered below
This bill changes how Medicare sets payment rates for diagnostic lab tests. For common tests, the government would collect pricing data from a large independent nonprofit database instead of asking labs to report what private insurers paid them. Rarer tests and cutting-edge diagnostic tests would follow separate rules.
Clinical laboratories and the patients who use Medicare-covered lab testing are most directly affected. Private insurance companies are also affected because their claims data would be used to set payment rates.
Changing the data source could affect how much Medicare pays labs for tests. The bill also caps how much payment rates can be cut in a single year and requires the government to publicly explain how each rate was calculated.
AI-drafted summary. Verify it against the official text before you act on it. Read the official bill on Congress.gov
Right now: a House committee is reviewing it. If the Senate changes it, it goes back to the House before reaching the President.
Latest 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.