I
119THCONGRESS
1
STSESSION H. R. 483
To direct the Secretary of Health and Human Services to delay the implemen-
tation of electronic clinical quality metrics for accountable care organiza-
tions, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JANUARY16, 2025
Mr. B
UCHANAN(for himself, Mr. PANETTA, and Mr. CRENSHAW) introduced
the following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, 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 com-
mittee concerned
A BILL
To direct the Secretary of Health and Human Services to
delay the implementation of electronic clinical quality
metrics for accountable care organizations, and for other
purposes.
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 ‘‘Health Care Efficiency 4
Through Flexibility Act’’. 5
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•HR 483 IH
SEC. 2. DELAY IN IMPLEMENTATION OF ECQMS FOR ACOS. 1
(a) D
ELAY OFECQM IMPLEMENTATION.—The Sec-2
retary of Health and Human Services (in this section re-3
ferred to as the ‘‘Secretary’’) shall delay the implementa-4
tion of the requirement for ACOs to transition from re-5
porting quality measures via the Centers for Medicare & 6
Medicare Services Web Interface portal to electronic Clin-7
ical Quality Metrics (eCQMs), as described in the rule ti-8
tled ‘‘Medicare and Medicaid Programs; CY 2025 Pay-9
ment Policies under the Physician Fee Schedule and Other 10
Changes to Part B Payment and Coverage Policies; Medi-11
care Shared Savings Program Requirements; Medicare 12
Prescription Drug Inflation Rebate Program; and Medi-13
care Overpayments’’ (89 Fed. Reg. 97710 (December 9, 14
2024)), until January 1, 2030. 15
(b) P
ILOTPROGRAM FOR DIGITALREPORTING 16
M
ETHODS.— 17
(1) I
N GENERAL.—Not later than January 1, 18
2026, the Secretary shall establish and commence a 19
pilot program to test digital reporting methods for 20
quality measures on a subset of ACOs and ACO par-21
ticipants that submit an application to participate in 22
such pilot program at such time and in such form 23
as the Secretary determines appropriate. 24
(2) T
EMPORARY EXEMPTION FROM ECQM RE -25
QUIREMENTS.—An ACO or an ACO participant par-26
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•HR 483 IH
ticipating in the pilot program shall be exempt from 1
mandatory eCQM reporting requirements during the 2
duration of the pilot program. 3
(3) N
O EFFECT ON PAYMENT INCENTIVES .— 4
Participation in the pilot program shall have no ef-5
fect on the eligibility of an ACO or an ACO partici-6
pant to qualify for or earn an incentive payment 7
under section 1833(z) of the Social Security Act (42 8
U.S.C. 1395l(z)) or a payment adjustment under 9
section 1848(q) of such Act (42 U.S.C. 1395w– 10
4(q)). 11
(4) T
ECHNICAL ASSISTANCE .—The Secretary 12
shall provide technical assistance, including waivers 13
from any applicable quality reporting requirements, 14
to ACOs and providers participating in the pilot pro-15
gram to incentivize their participation and to evalu-16
ate the efficacy of digital reporting methods. 17
(5) R
EPORT.—Not later than January 1, 2028, 18
the Secretary shall submit to Congress a report that 19
includes— 20
(A) the findings and results of the pilot 21
program carried out under paragraph (1); and 22
(B) any recommendations for increasing 23
the adoption by additional ACOs of the digital 24
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•HR 483 IH
reporting methods tested under such pilot pro-1
gram. 2
(c) D
EVELOPMENT OF LONG-TERMDIGITALQUAL-3
ITYREPORTINGSTANDARDS.— 4
(1) I
N GENERAL.—Not later than January 1, 5
2030, the Secretary shall implement standards for 6
digital quality reporting metrics and formats. Such 7
standards shall ensure that all EHR systems used 8
by an ACO are capable of supporting digital report-9
ing methods across a diverse range of practice sizes, 10
specialties, and geographic locations. 11
(2) C
ONSULTATION.—In developing the stand-12
ards described in paragraph (1), the Secretary shall 13
collaborate with relevant stakeholders, including rep-14
resentatives of the National Committee for Quality 15
Assurance, EHR vendors, ACOs, payers, and na-16
tional medical and specialty physician groups. 17
(d) C
ONTINUEDUSE OFEXISTINGREPORTING 18
M
ETHODS.— 19
(1) I
N GENERAL.—An ACO or ACO participant 20
may use the CMS Web Interface portal, MIPS 21
CQMs, Medicare CQMs, eCQMs, or any other pre-22
viously established quality reporting methods, for the 23
purpose of meeting such requirements until the date 24
on which the Secretary promulgates the standard-25
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•HR 483 IH
ized digital quality reporting methods under sub-1
section (c). 2
(2) E
XEMPTION.—No penalties shall be im-3
posed on ACOs or ACO participants for failure to 4
comply with eCQM requirements during the period 5
prior to January 1, 2030, provided they are in com-6
pliance with existing reporting methods. 7
(e) D
EFINITIONS.—In this section: 8
(1) ACO.—The term ‘‘ACO’’ has the meaning 9
given the term ‘‘accountable care organization’’ in 10
section 425.20 of title 42, Code of Federal Regula-11
tions. 12
(2) ACO
PARTICIPANT.—The term ‘‘ACO par-13
ticipant’’ has the meaning given such term in section 14
425.20 of title 42, Code of Federal Regulations. 15
(3) EHR.—The term ‘‘EHR’’ has the meaning 16
given the term ‘‘certified EHR technology’’ in sec-17
tion 1848(o) of the Social Security Act (42 U.S.C. 18
1395w–4(o)). 19
Æ
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