I 
119TH CONGRESS 
1ST SESSION H. R. 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. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 10, 2025 
Mr. 
HUDSON
(for 
himself, 
Mr. 
PETERS, 
Mr. 
BILIRAKIS, 
Mr. 
KRISHNAMOORTHI, Mr. FITZPATRICK, Mr. CARTER of Georgia, Mr. 
JOYCE of Pennsylvania, Mr. CISCOMANI, Mr. DAVIS of North Carolina, 
Ms. DAVIDS of Kansas, Ms. ROSS, Mr. BALDERSON, and Ms. SEWELL) 
introduced the following bill; which was referred to the Committee on En-
ergy 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 jurisdic-
tion of the committee concerned 
A BILL 
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 accu-
racy 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 pur-
poses. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Reforming and En-
hancing Sustainable Updates to Laboratory Testing Serv-
ices Act of 2025’’ or the ‘‘RESULTS Act’’. 
SEC. 2. IMPROVING THE ACCURACY AND DATA COLLEC-
TION FEASIBILITY OF THE PRIVATE PAYOR- 
BASED 
MEDICARE 
PAYMENT 
RATES 
FOR 
CLINICAL DIAGNOSTIC LABORATORY TESTS. 
(a) ACQUIRING DATA FOR WIDELY AVAILABLE NON- 
ADVANCED DIAGNOSTIC LABORATORY TESTS FROM
A 
QUALIFYING COMPREHENSIVE CLAIMS DATABASE OF AN 
INDEPENDENT NATIONAL NONPROFIT ENTITY.—Section 
1834A(a) of the Social Security Act (42 U.S.C. 1395m– 
1(a)) is amended— 
(1) in paragraph (1)— 
(A) in subparagraph (A)— 
(i) by striking ‘‘REQUIREMENTS.— 
Subject to subparagraph (B)’’ and insert-
ing ‘‘REQUIREMENTS.— 
‘‘(i) IN
GENERAL.—Subject to sub-
paragraph (B) and except as provided for 
in clause (ii)’’; 
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(ii) in clause (i), as added by clause 
(i) of this subparagraph— 
(I) by striking ‘‘paragraph (2)’’ 
and inserting ‘‘paragraph (2)(A)’’; 
(II) by inserting ‘‘, in accordance 
with the provisions of this section,’’ 
before ‘‘report to the Secretary’’; 
(III) by striking ‘‘applicable in-
formation (as defined in paragraph 
(3)) for a data collection period (as 
defined in paragraph (4))’’ and insert-
ing ‘‘applicable information (as de-
fined in paragraph (3))— 
‘‘(I) for a data collection period 
(as defined in paragraph (4)) begin-
ning before January 1, 2027,’’; 
(IV) by striking the period at the 
end and inserting ‘‘; and’’; and 
(V) by adding at the end the fol-
lowing new subclause: 
‘‘(II) for a data collection period 
beginning on or after January 1, 
2027, for each clinical diagnostic lab-
oratory test for which final payment is 
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made under this part to the labora-
tory during such period.’’; and 
(iii) by adding at the end the fol-
lowing new clause; 
‘‘(ii) COLLECTION
AND
SUBMISSION 
OF DATA.— 
‘‘(I) IN GENERAL.—With respect 
to data collection periods for reporting 
periods beginning on or after January 
1, 2028, and for purposes of this sec-
tion, in the case of a widely available 
non-ADLT clinical diagnostic labora-
tory test (as defined in paragraph 
(2)(E)), the Secretary shall collect 
and use applicable information from a 
qualifying comprehensive claims data-
base (as defined in paragraph (2)(C)) 
of a qualifying independent claims 
data entity (as defined in paragraph 
(2)(D)) with which the Secretary has 
in effect a contract under subclause 
(II) for each such test furnished dur-
ing the respective data collection pe-
riod and for which final payment is 
made under this part during the year 
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in which such data collection period 
occurs. 
‘‘(II) CONTRACT
WITH
QUALI-
FYING
INDEPENDENT
CLAIMS
DATA 
ENTITY FOR ACCESS TO APPLICABLE 
INFORMATION.—As soon as prac-
ticable after the date of enactment of 
this clause, the Secretary shall iden-
tify and enter into a contract with a 
qualifying independent claims data en-
tity for the purpose of, with respect to 
widely available non-ADLT clinical di-
agnostic laboratory tests furnished 
during a data collection period, such 
entity reporting to the Secretary ap-
plicable information from a qualifying 
comprehensive claims database of the 
entity for such tests for which final 
payment is made under this part dur-
ing the year in which such data collec-
tion period occurs and for which there 
is applicable information within such 
database for such period.’’. 
(B) in subparagraph (B)— 
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(i) in clause (i), by striking ‘‘2025’’ 
and inserting ‘‘2027’’; 
(ii) in clause (ii), by striking ‘‘begin-
ning January 1, 2026, and ending March 
31, 2026’’ and inserting ‘‘beginning Janu-
ary 1, 2028, and ending March 31, 2028’’; 
and 
(iii) in clause (iii), by striking ‘‘three 
years’’ and inserting ‘‘4 years’’; 
(2) in paragraph (2)— 
(A) by striking ‘‘DEFINITION OF APPLICA-
BLE LABORATORY.—In this section, the term 
‘applicable laboratory’ means’’ and inserting 
‘‘DEFINITIONS.—In this section:’’ 
‘‘(A) APPLICABLE LABORATORY.— 
‘‘(i) REPORTING
PERIODS
BEFORE 
2028.—With respect to reporting periods 
beginning before January 1, 2028, the 
term ‘applicable laboratory’ means’’; 
(B) in subparagraph (A), as inserted by 
subparagraph (A) of this paragraph— 
(i) in clause (i), in the second sen-
tence, by striking ‘‘paragraph’’ and insert-
ing ‘‘clause’’; and 
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(ii) by adding at the end the following 
new clause: 
‘‘(ii) REPORTING PERIODS BEGINNING 
DURING 2028 AND SUBSEQUENT YEARS.— 
With respect to reporting periods begin-
ning on or after January 1, 2028, the term 
‘applicable laboratory’ shall have the mean-
ing given such term in section 414.502 of 
title 42, Code of Federal Regulations, as in 
effect on May 1, 2025, except without ap-
plication of paragraph (3) of such sec-
tion.’’; and 
(C) by adding at the end the following new 
subparagraphs: 
‘‘(B) NON-WIDELY AVAILABLE NON-ADLT 
CLINICAL
DIAGNOSTIC
LABORATORY
TEST.— 
The term ‘non-widely available non-ADLT clin-
ical diagnostic laboratory test’ means, with re-
spect to a reporting period, a clinical diagnostic 
laboratory test that is not an advanced diag-
nostic laboratory test and that is not described 
in subparagraph (E). 
‘‘(C) QUALIFYING
INDEPENDENT
CLAIMS 
DATA
ENTITY.—The term ‘qualifying inde-
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pendent claims data entity’ means an entity 
that satisfies each of the following criteria: 
‘‘(i) The entity is a national nonprofit 
organization that is not affiliated with any 
Government 
agency, 
insurance 
issuer, 
group health plan, provider of services or 
supplier, or other organization in the 
health care sector. 
‘‘(ii) The entity collects data and 
maintains 
a 
qualifying 
comprehensive 
claims database (as defined in subpara-
graph (D)). 
‘‘(iii) The entity is certified by the 
Secretary to be a qualified entity (as de-
fined in paragraph (2) of section 1874(e)) 
with respect to having access to data de-
scribed in paragraph (3) of such section. 
‘‘(iv) The entity, with respect to all 
data included in the qualifying comprehen-
sive claims database of the entity, complies 
with all applicable Federal and State pri-
vacy and security requirements, including 
HIPAA privacy and security law (as de-
fined in section 3009 of the Public Health 
Service Act). 
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‘‘(v) The entity applies quality assur-
ance processes to validate all data that is 
included in the qualifying comprehensive 
claims database of the entity, including 
comprehensive statistical testing. 
‘‘(D) 
QUALIFYING
COMPREHENSIVE 
CLAIMS DATABASE.—The term ‘qualifying com-
prehensive claims database’ means an inde-
pendent database of private payor claims data, 
which— 
‘‘(i) includes at least 50,000,000,000 
claims from more than 50 private payors 
and claims administrators; 
‘‘(ii) is a statistically significant repos-
itory of claims data that is representative 
for all 50 States and the District of Co-
lumbia; 
‘‘(iii) includes only data that is vali-
dated by quality assurance processes, in-
cluding comprehensive statistical testing; 
‘‘(iv) complies with all applicable Fed-
eral and State privacy and security re-
quirements, as described in subparagraph 
(C)(iv); 
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