| 1 | 1 | | I |
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| 2 | 2 | | 119THCONGRESS |
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| 3 | 3 | | 1 |
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| 4 | 4 | | STSESSION H. R. 1924 |
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| 5 | 5 | | To amend title XVIII of the Social Security Act to establish a new criterion |
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| 6 | 6 | | for the nonapplication of site-neutral payments to long-term care hos- |
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| 7 | 7 | | pitals under the Medicare program. |
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| 8 | 8 | | IN THE HOUSE OF REPRESENTATIVES |
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| 9 | 9 | | MARCH6, 2025 |
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| 10 | 10 | | Mr. H |
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| 11 | 11 | | ERNof Oklahoma (for himself, Mr. BOYLEof Pennsylvania, Mr. JOYCE |
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| 12 | 12 | | of Pennsylvania, Mrs. M |
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| 13 | 13 | | ILLERof West Virginia, Mr. SMUCKER, and Ms. |
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| 14 | 14 | | T |
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| 15 | 15 | | ENNEY) introduced the following bill; which was referred to the Com- |
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| 16 | 16 | | mittee on Ways and Means |
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| 17 | 17 | | A BILL |
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| 18 | 18 | | To amend title XVIII of the Social Security Act to establish |
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| 19 | 19 | | a new criterion for the nonapplication of site-neutral |
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| 20 | 20 | | payments to long-term care hospitals under the Medicare |
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| 21 | 21 | | program. |
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| 22 | 22 | | Be it enacted by the Senate and House of Representa-1 |
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| 23 | 23 | | tives of the United States of America in Congress assembled, 2 |
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| 24 | 24 | | SECTION 1. SHORT TITLE. 3 |
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| 25 | 25 | | This Act may be cited as the ‘‘Securing Access to 4 |
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| 26 | 26 | | Care for Seniors in Critical Condition Act of 2025’’. 5 |
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| 27 | 27 | | VerDate Sep 11 2014 00:10 Mar 20, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1924.IH H1924 |
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| 28 | 28 | | ssavage on LAPJG3WLY3PROD with BILLS 2 |
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| 29 | 29 | | •HR 1924 IH |
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| 30 | 30 | | SEC. 2. ESTABLISHING A NEW CRITERION FOR THE NON-1 |
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| 31 | 31 | | APPLICATION OF SITE-NEUTRAL PAYMENTS 2 |
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| 32 | 32 | | TO LONG-TERM CARE HOSPITALS UNDER 3 |
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| 33 | 33 | | THE MEDICARE PROGRAM. 4 |
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| 34 | 34 | | Section 1886(m)(6)(A) of the Social Security Act (42 5 |
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| 35 | 35 | | U.S.C. 1395ww(m)(6)(A)) is amended— 6 |
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| 36 | 36 | | (1) in clause (ii)(I), by striking ‘‘or the venti-7 |
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| 37 | 37 | | lator criterion under clause (iv)’’ and inserting ‘‘, the 8 |
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| 38 | 38 | | ventilator criterion under clause (iv), or the high 9 |
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| 39 | 39 | | acuity criterion described in clause (v)’’; and 10 |
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| 40 | 40 | | (2) by adding at the end the following new 11 |
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| 41 | 41 | | clause: 12 |
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| 42 | 42 | | ‘‘(v) H |
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| 43 | 43 | | IGH ACUITY CRITERION .—The 13 |
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| 44 | 44 | | criterion specified in this clause (in this 14 |
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| 45 | 45 | | paragraph referred to as the ‘high acuity 15 |
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| 46 | 46 | | criterion’) for a discharge from a long-term 16 |
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| 47 | 47 | | care hospital in a fiscal year is that— 17 |
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| 48 | 48 | | ‘‘(I) the discharge was assigned 18 |
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| 49 | 49 | | to a Medicare-Severity-Long-Term- 19 |
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| 50 | 50 | | Care-Diagnosis-Related-Group (MS- 20 |
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| 51 | 51 | | LTC-DRG) with a relative weight for 21 |
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| 52 | 52 | | such fiscal year that was equal to or 22 |
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| 53 | 53 | | greater than 0.8; and 23 |
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| 54 | 54 | | ‘‘(II) the discharge occurred on 24 |
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| 55 | 55 | | or after October 1, 2026.’’. 25 |
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| 56 | 56 | | Æ |
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| 57 | 57 | | VerDate Sep 11 2014 00:10 Mar 20, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6301 E:\BILLS\H1924.IH H1924 |
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| 58 | 58 | | ssavage on LAPJG3WLY3PROD with BILLS |
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