Revising Phase-In of Medicare Clinical Laboratory Test Payment Changes
Section 6226 · Sec. 6226 ·
What this chapter is about
This part moves the years and dates in a phase-in for lab test payment. It changes which years the reporting data comes from. It also moves the reporting window from winter to spring.
The document says “is amended”Who acts: CongressHow: statuteSec. 6226 in the PDF
What the document says
“in clause (iii), by striking ``the period beginning on January 31, 2026, and ending on December 31, 2026, and for each of 2027 and 2028'' and inserting ``each of 2027 through 2029''.”
Subsection (a) of section 6226 amends section 1834A(b)(3) of the Social Security Act. It strikes 2028 and inserts 2029 in subparagraph (A), replaces the 2025 and early 2026 period with 2026 in clause (ii), and replaces the 2026 period and 2027 and 2028 with each of 2027 through 2029 in clause (iii).
What the document actually says
“in clause (iii), by striking ``the period beginning on January 31, 2026, and ending on December 31, 2026, and for each of 2027 and 2028'' and inserting ``each of 2027 through 2029''.”
That sentence, in plain words
Cross out the words naming part of 2026 and two later years. Write in words naming each of 2027 through 2029.
What this is about
A phase-in brings a payment change in over several years. Moving the years moves when each step falls.
No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.
The document says “is amended”Who acts: CongressHow: statuteSec. 6226 in the PDF
What the document says
“Section 1834A(a)(4)(B) of the Social Security Act (42 U.S.C. 1395m-1(a)(4)(B)) is amended by striking ``2019'' each place it appears and inserting ``2025'' in each such place.”
Subsection (b) of section 6226 amends section 1834A(a)(4)(B) of the Social Security Act, striking 2019 in each place it appears and inserting 2025.
What the document actually says
“Section 1834A(a)(4)(B) of the Social Security Act (42 U.S.C. 1395m-1(a)(4)(B)) is amended by striking ``2019'' each place it appears and inserting ``2025'' in each such place.”
That sentence, in plain words
In one part of the law, cross out the year 2019 each time it shows up. Write in the year 2025 in each spot.
What this is about
Labs report what private payers pay them. The rates the government sets are built from that data. This moves which year the data comes from.
No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.
The document says “is amended”Who acts: CongressHow: statuteSec. 6226 in the PDF
What the document says
“(1) in clause (i), by striking ``January 31'' and inserting ``April 30''; and
(2) in clause (ii), by striking ``February 1, 2026, and ending April 30, 2026'' and inserting ``May 1, 2026, and ending July 31, 2026''.”
Subsection (c) of section 6226 amends section 1834A(a)(1)(B) of the Social Security Act, moving a deadline from January 31 to April 30 and moving a reporting period from February through April 2026 to May through July 2026.
What the document actually says
“(1) in clause (i), by striking ``January 31'' and inserting ``April 30''; and
(2) in clause (ii), by striking ``February 1, 2026, and ending April 30, 2026'' and inserting ``May 1, 2026, and ending July 31, 2026''.”
That sentence, in plain words
Cross out January 31 and write in April 30. In the next spot, move a window three months later.
What this is about
Labs have a set window in which to send their data. This shifts that window into spring. It gives them more time.
No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.
The document says “can”Who acts: Secretary of Health and Human ServicesHow: statuteSec. 6226 in the PDF
What the document says
“Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the amendments made by this section by program instruction or otherwise.”
Subsection (d) of section 6226 allows the Secretary of Health and Human Services to implement the amendments by program instruction or otherwise, notwithstanding any other provision of law.
What the document actually says
“Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the amendments made by this section by program instruction or otherwise.”
That sentence, in plain words
The health chief may put these changes in place through a program notice. Other law does not stand in the way.
What this is about
Writing a rule takes months of notice and comment. A program notice is faster. This part allows the faster path.
No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.
The four things the section does: revise the phase-in years, change the data collection period year, move the reporting period dates, and allow implementation by program instruction.
The strike-and-insert instructions one by one where the same change is made in more than one place.
The section amends section 1834A of the Social Security Act, which is not indexed here, so how the lab payment rates are set is not recorded on this site.
