I
119THCONGRESS
1
STSESSION H. R. 1924
To amend title XVIII of the Social Security Act to establish a new criterion
for the nonapplication of site-neutral payments to long-term care hos-
pitals under the Medicare program.
IN THE HOUSE OF REPRESENTATIVES
MARCH6, 2025
Mr. H
ERNof Oklahoma (for himself, Mr. BOYLEof Pennsylvania, Mr. JOYCE
of Pennsylvania, Mrs. M
ILLERof West Virginia, Mr. SMUCKER, and Ms.
T
ENNEY) introduced the following bill; which was referred to the Com-
mittee on Ways and Means
A BILL
To amend title XVIII of the Social Security Act to establish
a new criterion for the nonapplication of site-neutral
payments to long-term care hospitals under the Medicare
program.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Securing Access to 4
Care for Seniors in Critical Condition Act of 2025’’. 5
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•HR 1924 IH
SEC. 2. ESTABLISHING A NEW CRITERION FOR THE NON-1
APPLICATION OF SITE-NEUTRAL PAYMENTS 2
TO LONG-TERM CARE HOSPITALS UNDER 3
THE MEDICARE PROGRAM. 4
Section 1886(m)(6)(A) of the Social Security Act (42 5
U.S.C. 1395ww(m)(6)(A)) is amended— 6
(1) in clause (ii)(I), by striking ‘‘or the venti-7
lator criterion under clause (iv)’’ and inserting ‘‘, the 8
ventilator criterion under clause (iv), or the high 9
acuity criterion described in clause (v)’’; and 10
(2) by adding at the end the following new 11
clause: 12
‘‘(v) H
IGH ACUITY CRITERION .—The 13
criterion specified in this clause (in this 14
paragraph referred to as the ‘high acuity 15
criterion’) for a discharge from a long-term 16
care hospital in a fiscal year is that— 17
‘‘(I) the discharge was assigned 18
to a Medicare-Severity-Long-Term- 19
Care-Diagnosis-Related-Group (MS- 20
LTC-DRG) with a relative weight for 21
such fiscal year that was equal to or 22
greater than 0.8; and 23
‘‘(II) the discharge occurred on 24
or after October 1, 2026.’’. 25
Æ
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