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Health Care Efficiency Through Flexibility Act

Introduced Sep 15, 2025 · Last action Jun 29, 2026 Motion to reconsider laid on the table Agreed to without objection.

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Summary

This legislation is called the Health Care Efficiency Through Flexibility Act. Motion to reconsider laid on the table Agreed to without objection.

Full bill text

[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>

Official legislative text sourced from the public record (cached on CivicsHQ).

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Status

Passed Chamber

  1. 1Introduced
  2. 2Committee
  3. 3Floor
  4. 4Passed
  5. 5Signed

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