Hospital Inpatient Services Modernization Act

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4313 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 4313

    To amend title XVIII of the Social Security Act to extend acute
     hospital care at home waiver flexibilities, and to require an
           additional study and report on such flexibilities.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             July 10, 2025

Mr. Buchanan (for himself, Mr. Smucker, and Mr. Evans of Pennsylvania)
 introduced the following bill; which was referred to the Committee on
                             Ways and Means

_______________________________________________________________________

                                 A BILL

    To amend title XVIII of the Social Security Act to extend acute
     hospital care at home waiver flexibilities, and to require an
           additional study and report on such flexibilities.

    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 ``Hospital Inpatient Services
Modernization Act''.

SEC. 2. EXTENDING ACUTE HOSPITAL CARE AT HOME WAIVER FLEXIBILITIES.

    Section 1866G(a)(1) of the Social Security Act (42 U.S.C. 1395cc-
7(a)(1)) is amended by striking ``2025'' and inserting ``2030''.

SEC. 3. REQUIRING ADDITIONAL STUDY AND REPORT ON ACUTE HOSPITAL CARE AT
              HOME WAIVER FLEXIBILITIES.

    Section 1866G of the Social Security Act (42 U.S.C. 1395cc-7), as
amended by section 2, is further amended--
            (3) in subsection (b), in the subsection heading, by
        striking ``Study'' and inserting ``Initial Study'';
            (4) by redesignating subsections (c) and (d) as subsections
        (d) and (e), respectively; and
            (5) by inserting after subsection (b) the following new
        subsection:
    ``(c) Subsequent Study and Report.--
            ``(1) In general.--Not later than September 30, 2028, the
        Secretary shall conduct a study to--
                    ``(A) analyze, to the extent practicable, the
                criteria established by hospitals under the Acute
                Hospital Care at Home initiative to determine which
                individuals may be furnished services under such
                initiative; and
                    ``(B) analyze and compare (both within and between
                hospitals participating in the initiative, and relative
                to comparable hospitals that do not participate in the
                initiative, for relevant parameters such as diagnosis-
                related groups)--
                            ``(i) quality of care furnished to
                        individuals with similar conditions and
                        characteristics in the inpatient setting and
                        through the Acute Hospital Care at Home
                        initiative, including health outcomes, hospital
                        readmission rates (including readmissions both
                        within and beyond 30 days post-discharge),
                        hospital mortality rates, length of stay,
                        infection rates, composition of care team
                        (including the types of labor used, such as
                        contracted labor), the ratio of nursing staff,
                        transfers from the hospital to the home,
                        transfers from the home to the hospital
                        (including the timing, frequency, and causes of
                        such transfers), transfers and discharges to
                        post-acute care settings (including the timing,
                        frequency, and causes of such transfers and
                        discharges), and patient and caregiver
                        experience of care;
                            ``(ii) clinical conditions treated and
                        diagnosis-related groups of discharges from
                        inpatient settings relative to discharges from
                        the Acute Hospital Care at Home initiative;
                            ``(iii) costs incurred by the hospital for
                        furnishing care in inpatient settings relative
                        to costs incurred by the hospital for
                        furnishing care through the Acute Hospital Care
                        at Home initiative, including costs relating to
                        staffing, equipment, food, prescriptions, and
                        other services, as determined by the Secretary;
                            ``(iv) the quantity, mix, and intensity of
                        services (such as in-person visits and virtual
                        contacts with patients and the intensity of
                        such services) furnished in inpatient settings
                        relative to the Acute Hospital Care at Home
                        initiative, and, to the extent practicable, the
                        nature and extent of family or caregiver
                        involvement;
                            ``(v) socioeconomic information on
                        individuals treated in comparable inpatient
                        settings relative to the initiative, including
                        racial and ethnic data, income, housing,
                        geographic proximity to the brick-and-mortar
                        facility and whether such individuals are
                        dually eligible for benefits under this title
                        and title XIX; and
                            ``(vi) the quality of care, outcomes,
                        costs, quantity and intensity of services, and
                        other relevant metrics between individuals who
                        entered into the Acute Hospital Care at Home
                        initiative directly from an emergency
                        department compared with individuals who
                        entered into the Acute Hospital Care at Home
                        initiative directly from an existing inpatient
                        stay in a hospital.
            ``(2) Selection bias.--In conducting the study under
        paragraph (1), the Secretary shall, to the extent practicable,
        analyze and compare individuals who participate and do not
        participate in the initiative controlling for selection bias or
        other factors that may impact the reliability of data.
            ``(3) Report.--Not later than September 30, 2028, the
        Secretary of Health and Human Services shall submit to the
        Committee on Ways and Means of the House of Representatives and
        the Committee on Finance of the Senate a report on the study
        conducted under paragraph (1).''.
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