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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5347 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 5347
To amend title XVIII of the Social Security Act to ensure the
availability of appropriate collection types for quality reporting
under the Medicare Shared Savings Program, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 15, 2025
Mr. Buchanan (for himself, Mr. Panetta, Mr. Crenshaw, and Mr. LaHood)
introduced the following bill; which was referred to the Committee on
Ways and Means, and in addition to the Committee on Energy and
Commerce, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to ensure the
availability of appropriate collection types for quality reporting
under the Medicare Shared Savings Program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Care Efficiency Through
Flexibility Act''.
SEC. 2. ENSURING AVAILABILITY OF APPROPRIATE COLLECTION TYPES FOR
QUALITY REPORTING UNDER THE MEDICARE SHARED SAVINGS
PROGRAM.
Section 1899(b)(3)(B) of the Social Security Act (42 U.S.C.
1395jjj(b)(3)(B)) is amended--
(1) by striking ``An ACO shall submit'' and inserting the
following:
``(i) In general.--An ACO shall submit'';
and
(2) by adding at the end the following new clauses:
``(ii) Required availability of collection
types for certain years.--For performance years
2025 through 2029, the Secretary shall ensure
that the following collection types (as
described in section 414.1305 of title 42, Code
of Federal Regulations (or a successor
regulation)) are available with respect to each
measure described in subparagraph (A)(i)
required to be reported by an ACO under this
paragraph:
``(I) Electronic clinical quality
measures.
``(II) MIPS clinical quality
measures.
``(III) Medicare Clinical Quality
Measures for Accountable Care
Organizations Participating in the
Medicare Shared Savings Program.
``(iii) Clarification on application of
data completeness requirements in certain
cases.--
``(I) In general.--In determining
whether data submitted by an ACO with
respect to a measure described in
subparagraph (A)(i) for a performance
year beginning on or after January 1,
2025, satisfies the data completeness
requirements applicable to such measure
under section 414.1340 of title 42,
Code of Federal Regulations (or a
successor regulation) (as applied
pursuant to section 425.512 of title
42, Code of Federal Regulations (or a
successor regulation)), the Secretary
may not find such data to be
unrepresentative of such ACO's
performance for such year (as described
in paragraph (e) of such section
414.1340) based solely on the fact that
such data excludes applicable data from
1 or more ACO participants in such ACO
if--
``(aa) such data submitted
by the ACO otherwise complies
with the data completeness
requirements of such section
414.1340; and
``(bb) such ACO
demonstrates to the
satisfaction of the Secretary
that such ACO participant was
unable to collect such data
through the collection type (as
described in clause (ii))
selected by the ACO for the
submission of such data.
``(II) Definition.--In this clause,
the term `ACO participant' has the
meaning given such term in section
425.20 of title 42, Code of Federal
Regulations (or a successor
regulation).
``(III) Implementation.--The
Secretary may implement this clause by
program instruction or otherwise.''.
SEC. 3. PILOT PROGRAM FOR DIGITAL QUALITY MEASURE REPORTING.
Section 1899(b)(3)(B) of the Social Security Act (42 U.S.C.
1395jjj(b)(3)(B)), as amended by section 2, is further amended by
adding at the end the following new clause:
``(iv) Pilot program for digital quality
measure reporting.--
``(I) In general.--For each of
performance years 2028 through 2032,
the Secretary shall establish a digital
quality measure reporting pilot program
(in this clause referred to as the
`program') under which ACOs selected
under subclause (II) for such
performance year report quality
measures specified by the Secretary
under subclause (III) for such
performance year through a digital
quality measure collection type
specified by the Secretary.
``(II) Selection.--The Secretary
shall select ACOs to participate in the
program for a performance year from
among ACOs that submit an application
at such time and in such form and
manner as specified by the Secretary.
``(III) Specification of quality
measures.--For each performance year of
the program, the Secretary shall
specify 2 measures described in
subparagraph (A)(i) otherwise required
to be reported by ACOs for such
performance year for which an ACO
selected under subclause (II) shall
submit data through the collection type
specified in subclause (I).
``(IV) Waiver of requirement to
report other measures.--The Secretary
may not require an ACO selected under
subclause (II) for a performance year
to report data on any measure described
in subparagraph (A) otherwise required
to be reported by an ACO under this
paragraph for such performance year,
other than such a measure specified
under subclause (III) for such
performance year.
``(V) Disregard of data for certain
measures.--The Secretary may not take
into account any data for a measure
specified under subclause (III) for a
performance year submitted by an ACO
selected under subclause (II) for such
performance year, or any data for a
measure with respect to which such ACO
is not required to report data for such
performance year under subclause (IV),
in determining--
``(aa) whether such ACO has
met quality performance
standards established by the
Secretary under subparagraph
(C) for such performance year;
or
``(bb) any score for the
quality performance category
(as described in section
1848(q)(2)(A)(i)) for an ACO
participant (as defined in
clause (iii)(II)) in such ACO
for such performance year.
``(VI) Technical assistance.--The
Secretary shall provide such technical
assistance to ACOs selected to
participate in the program as is
practicable.
``(VII) Provision of information.--
Not later than December 31, 2032, the
Secretary shall publicly post (or
include as part of annual rulemaking
for this section) the following:
``(aa) An analysis of the
program.
``(bb) Any recommendations
for increasing submissions of
data for measures described in
subparagraph (A)(i) through the
collection type specified in
subclause (I).
``(cc) A proposed timeline
for requiring such measures to
be submitted through such
collection type.''.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Committee Consideration and Mark-up Session Held
Ordered to be Reported in the Nature of a Substitute (Amended) by the Yeas and Nays: 43 - 0.
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