Brian Babin

Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act of 2025 or the RESULTS Act

This bill requires the use of particular data from the private sector to inform Medicare payment rates for certain widely available laboratory tests.

Specifically, the Centers for Medicare & Medicaid Services (CMS) must contract with an entity that maintains a database of claims data for clinical diagnostic laboratory tests that (1) are not advanced diagnostic tests, and (2) were furnished by more than 100 providers and suppliers of such services over a specified six-month period (i.e., widely available tests).

The database must meet specified requirements, such as having data that is representative of the entire country and from more than 50 private payors and claims administrators. The contracted entity must be a nonprofit entity that is not affiliated with any government agency, any insurance issuer or provider, or any other organization in the health care sector.

Beginning January 1, 2028, the CMS must use the information obtained from the database to inform Medicare payment rates for these widely available laboratory tests.

The bill additionally specifies processes for determining payment rates for laboratory tests that are not advanced diagnostic tests, are not widely available, and lack adequate claims data. The CMS must use certain existing processes to set appropriate rates.

The bill also delays scheduled payment reductions for laboratory tests until 2028 and allows for judicial and administrative review of payment rates.

Heat Workforce Standards Act of 2025

This bill prohibits the Occupational Safety and Health Administration (OSHA) from finalizing, implementing, or enforcing a safety standard requiring certain employers to create a heat injury and illness prevention plan to evaluate and control heat hazards in their workplaces.

Specifically, OSHA is prohibited from finalizing the proposed rule titled Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings, which was published on August 30, 2024, or any substantially similar standard. The proposed standard generally applies to employers conducting outdoor and indoor work in all general industry, construction, maritime, and agriculture sectors where OSHA has jurisdiction. Employers must develop plans in accordance with the specified standards to address employee exposures to heat indexes at or above 80 degrees (initial heat trigger) or 90 degrees (high heat trigger) Fahrenheit.

As background, the Occupational Safety and Health Act of 1970 generally requires employers to provide their employees with a place of employment that is free from recognized hazards that are causing or likely to cause death or serious harm to employees. OSHA conducts workplace inspections and cites employers that fail to satisfy these requirements. Currently, OSHA does not have specific heat exposure standards; however, OSHA has historically used its general authority to cite employers for violations involving excessive heat, including through a National Emphasis Program that focuses on indoor and outdoor heat exposure in industries that have the highest risks.

Title IX Clarification Act of 2026

This bill defines the terms sex, female, and male for purposes of Title IX of the Education Amendments of 1972. Title IX prohibits discrimination on the basis of sex in education programs that receive federal financial assistance.

Specifically, the bill defines sex as an individual’s biologically determined sex, as either male or female. Therefore, Title IX's prohibition on sex discrimination only applies to biological sex under the bill.

The bill defines female, when used with respect to a natural person, as an individual who naturally has, had, will have, or would have, but for a congenital anomaly, historical accident, or intentional or unintentional disruption, the reproductive system that at some point produces, transports, and utilizes the large gamete (ova) for fertilization.

The bill defines male, when used with respect to a natural person, as an individual who naturally has, had, will have, or would have, but for a congenital anomaly, historical accident, or intentional or unintentional disruption, the reproductive system that at some point produces, transports, and utilizes the small gamete (sperm) for fertilization.

(A January 20, 2025, executive order stated that it is the policy of the United States to recognize two sexes—male and female—which are not changeable. On February 4, 2025, the Department of Education announced its intent to enforce its Title IX regulations consistent with this executive order. For more information on the status of these regulations, see LBS11279.)

Improving Seniors' Timely Access to Care Act of 2025

This bill establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans.

Specifically, MA plans must (1) establish an electronic prior authorization program that meets specified standards; (2) annually submit to the CMS for publication specified prior authorization information, including the percentage of requests approved and the average response time; and (3) meet other standards, as set by the Centers for Medicare & Medicaid Services (CMS), relating to the quality and timeliness of prior authorization determinations.

The CMS and the Office of the National Coordinator for Health Information Technology must publish on the CMS' website a report that analyzes the information received from MA plans, the feasibility of implementing real-time decision making with respect to prior authorization requests, and the impact of decisions that are made using artificial intelligence on patient access.

This concurrent resolution expresses support for law enforcement officers. It also appreciates the contributions and recognizes the sacrifices of law enforcement officers.

Provider Reimbursement Stability Act of 2026

This bill allows for larger annual adjustments to the Medicare physician fee schedule. It also requires the Centers for Medicare & Medicaid Services (CMS) to make certain corrections to compensate for expenditures under the fee schedule that exceed a certain amount in a given year, and it limits how much certain adjustment factors may vary each year.

Current law prohibits annual adjustments to the Medicare physician fee schedule that would result in a more than $20 million difference between the adjusted amount and the non-adjusted amount of total expenditures. The bill increases this threshold to $54.3 million beginning in 2027, with adjustments for inflation every five years beginning in 2032.

Additionally, for certain services, the bill requires the CMS to determine the difference between expenditures based on estimated utilization of the service and expenditures based on actual utilization. If this difference exceeds a certain percentage of total expenditures under the fee schedule, the CMS must reconcile this difference by adjusting payments for the following year. This requirement applies to services for which payment was bundled with another service and there was a separate or add-on payment during the previous year.

Finally, the CMS must update the prices and rates of each category of direct costs that affect payments (e.g., prices of equipment) at least every five years, with updates made to each category in the same year. The bill also prohibits the CMS from varying a certain adjustment factor by more than 2.5% each year.