Bill would change how CMS sets lab reimbursement under Medicare fee schedule

Energy and Commerce: House Committee · January 8, 2026

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Summary

Representative Richard Hudson's HR 5269 would alter CMS procedures for establishing Medicare clinical laboratory fee schedule rates to rely more on private-payer rates and reduce administrative burden, the committee was told.

Unidentified Speaker said HR 5269, led by Representative Richard Hudson (NC), would update how CMS establishes reimbursement rates for clinical laboratory services paid under the Medicare clinical lab fee schedule. The speaker described the bill’s purpose as creating a “less burdensome process for CMS to determine private payer based rates for lab services.”

The opening statement did not include witness testimony or specific fiscal estimates. The committee said it will hear witnesses before advancing the bill to markup.