RESULTS Act
What does the RESULTS Act do?
HR 5269 is a House bill sponsored by Rep. Richard Hudson (R-NC). Medicare pays for clinical laboratory tests at rates built from what private insurers pay for the same tests, information laboratories currently have to report to the government themselves. For the tests billed by the most providers, this bill would have Medicare buy that information from an independent nonprofit claims database under contract instead, push the next laboratory reporting round from 2026 to 2028, and change the limit on how fast rates can fall: no reductions at all through 2028, then a permanent cap of 5 percent a year. Moves Medicare's private-payor rate data for the most widely billed lab tests from laboratory self-reporting to a contracted nonprofit claims database, delays the next reporting round to 2028, and caps annual rate cuts at 5 percent from 2029 onward.
Did HR 5269 pass? Where it stands
As of August 27, 2026, HR 5269 has reached the In Committee stage.
Status: In Committee
Outlook: Possible
Key provisions
- How Medicare Sets Lab Rates Now
- Payment equals the weighted median of reported private-payor rates
- Laboratories report their own private rates and volumes
- Cuts capped at 10 percent for 2017-2020, then 0 percent through 2025
- Data Comes From a Claims Database
- Secretary contracts with a national nonprofit claims-data entity
- Database needs 50 billion claims from more than 50 private payors
- Covers tests paid to more than 100 providers and suppliers
- Rate Cut Limits and Review Rights
- No reductions allowed through 2028
- Reductions capped at 5 percent for 2029 and each later year
- Review bar lifts for rates established from 2029 onward
Last updated August 27, 2026