U.S.C. 1395m–1(a)(8)(C)) is amended by striking 
‘‘A medicaid managed care organization’’ and insert-
ing ‘‘With respect to data collection periods for re-
porting periods beginning before January 1, 2026, a 
medicaid managed care organization (as defined in 
section 1903(m))’’. 
(2) AUTHORITY TO EXCLUDE MANUAL REMIT-
TANCES.—Section 1834A(a)(3) of the Social Secu-
rity Act (42 U.S.C. 1395m–1(a)(3)) is amended— 
(A) in subparagraph (A), by striking ‘‘sub-
ject to subparagraph (B),’’ and inserting ‘‘sub-
ject to subparagraphs (B) and (C)’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(C) EXCLUSION
OF
MANUAL
REMIT-
TANCES.—An applicable laboratory for which 
less than 10 percent of its total paid claims 
during a data collection period are paid by pri-
vate payors by means other than an electronic 
standard transaction (as defined in section 
162.103 of title 45, Code of Federal Regula-
tions (or any successor regulation)) may exclude 
from the definition of applicable information 
under this paragraph payments made by private 
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payors that are not made through an electronic 
standard transaction.’’. 
(d) MODIFICATION TO LIMITS ON PAYMENT REDUC-
TIONS; IMPOSITION OF ANNUAL CAP ON PAYMENT IN-
CREASES.— 
(1) PAYMENT
REDUCTION
LIMITS.—Section 
1834A(b)(3) of the Social Security Act (42 U.S.C. 
1395m–1(b)(3)) is amended— 
(A) in subparagraph (A), by striking ‘‘for 
each of 2017 through 2025’’ and inserting ‘‘for 
2017 and each succeeding year’’; and 
(B) in subparagraph (B)— 
(i) in clause (ii), by striking ‘‘and’’ at 
the end; and 
(ii) by striking clause (iii) and insert-
ing the following: 
‘‘(iii) for 2023, 0 percent; 
‘‘(iv) for 2024, 2.5 percent; and 
‘‘(v) for 2025 and each subsequent 
year, 5 percent.’’. 
(2) ANNUAL
CAP
ON
PAYMENT
RATE
IN-
CREASES.—Section 1834A(b)(3) of the Social Secu-
rity Act (42 U.S.C. 1395m–1(b)(3)), as amended by 
paragraph (1), is amended— 
(A) in subparagraph (A)— 
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(i) by striking ‘‘test for 2017 and 
each succeeding year—’’ and inserting 
‘‘test— 
‘‘(i) for 2017 and each succeeding 
year’’; 
(ii) in clause (i), as added by clause 
(i) of this subparagraph, by striking the 
period and inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing new clause: 
‘‘(ii) for 2023 and each succeeding 
year, shall not result in an increase in pay-
ments for a clinical diagnostic laboratory 
test for the year of greater than the appli-
cable percent (as defined in subparagraph 
(D)) of the amount of payment for the test 
for the preceding year.’’; 
(B) in subparagraph (B), in the matter 
preceding clause (i), by striking ‘‘In this para-
graph’’ and inserting ‘‘In clause (i) of subpara-
graph (A)’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(D) DEFINITION
OF
APPLICABLE
PER-
CENT FOR PURPOSES OF ANNUAL CAP ON PAY-
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MENT INCREASES.—In clause (ii) of subpara-
graph (A), the term ‘applicable percent’ means 
the following: 
‘‘(i) WIDELY AVAILABLE CLINICAL DI-
AGNOSTIC LABORATORY TESTS.—With re-
spect to a widely available clinical diag-
nostic laboratory test— 
‘‘(I) for 2023, 2.5 percent; 
‘‘(II) for 2024, 2.5 percent; 
‘‘(III) for 2025, 3.75 percent, 
‘‘(IV) for 2026, 3.75 percent; 
and 
‘‘(V) for 2027 and each subse-
quent year, 5 percent. 
‘‘(ii) OTHER
CLINICAL
DIAGNOSTIC 
LABORATORY
TESTS.—With respect to a 
clinical diagnostic laboratory test not de-
scribed in clause (i), 5 percent.’’. 
(3) 
CONFORMING
AMENDMENT.—Section 
1834A(b)(3) of the Social Security Act (42 U.S.C. 
1395m–1(b)(3)) is amended in the heading by strik-
ing ‘‘REDUCTIONS’’ and inserting ‘‘MEDICARE PAY-
MENT CHANGES’’. 
(e) REGULATIONS.—(1) Not later than December 31, 
2023, the Secretary of Health and Human Services shall 
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implement the amendments made by this section (other 
than subsection (d)) through notice and comment rule-
making. 
(2) The Secretary of Health and Human Services 
may implement the amendments made by subsection (d) 
through interim final rulemaking, program instruction, or 
otherwise. 
Æ 
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