Us Congress 2025-2026 Regular Session

Us Congress House Bill HB483 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 483
5	5	To direct the Secretary of Health and Human Services to delay the implemen-
6	6	tation of electronic clinical quality metrics for accountable care organiza-
7	7	tions, and for other purposes.
8	8	IN THE HOUSE OF REPRESENTATIVES
9	9	JANUARY16, 2025
10	10	Mr. B
11	11	UCHANAN(for himself, Mr. PANETTA, and Mr. CRENSHAW) introduced
12	12	the following bill; which was referred to the Committee on Energy and
13	13	Commerce, and in addition to the Committee on Ways and Means, for
14	14	a period to be subsequently determined by the Speaker, in each case for
15	15	consideration of such provisions as fall within the jurisdiction of the com-
16	16	mittee concerned
17	17	A BILL
18	18	To direct the Secretary of Health and Human Services to
19	19	delay the implementation of electronic clinical quality
20	20	metrics for accountable care organizations, and for other
21	21	purposes.
22	22	Be it enacted by the Senate and House of Representa-1
23	23	tives of the United States of America in Congress assembled, 2
24	24	SECTION 1. SHORT TITLE. 3
25	25	This Act may be cited as the ‘‘Health Care Efficiency 4
26	26	Through Flexibility Act’’. 5
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29	29	•HR 483 IH
30	30	SEC. 2. DELAY IN IMPLEMENTATION OF ECQMS FOR ACOS. 1
31	31	(a) D
32	32	ELAY OFECQM IMPLEMENTATION.—The Sec-2
33	33	retary of Health and Human Services (in this section re-3
34	34	ferred to as the ‘‘Secretary’’) shall delay the implementa-4
35	35	tion of the requirement for ACOs to transition from re-5
36	36	porting quality measures via the Centers for Medicare & 6
37	37	Medicare Services Web Interface portal to electronic Clin-7
38	38	ical Quality Metrics (eCQMs), as described in the rule ti-8
39	39	tled ‘‘Medicare and Medicaid Programs; CY 2025 Pay-9
40	40	ment Policies under the Physician Fee Schedule and Other 10
41	41	Changes to Part B Payment and Coverage Policies; Medi-11
42	42	care Shared Savings Program Requirements; Medicare 12
43	43	Prescription Drug Inflation Rebate Program; and Medi-13
44	44	care Overpayments’’ (89 Fed. Reg. 97710 (December 9, 14
45	45	2024)), until January 1, 2030. 15
46	46	(b) P
47	47	ILOTPROGRAM FOR DIGITALREPORTING 16
48	48	M
49	49	ETHODS.— 17
50	50	(1) I
51	51	N GENERAL.—Not later than January 1, 18
52	52	2026, the Secretary shall establish and commence a 19
53	53	pilot program to test digital reporting methods for 20
54	54	quality measures on a subset of ACOs and ACO par-21
55	55	ticipants that submit an application to participate in 22
56	56	such pilot program at such time and in such form 23
57	57	as the Secretary determines appropriate. 24
58	58	(2) T
59	59	EMPORARY EXEMPTION FROM ECQM RE -25
60	60	QUIREMENTS.—An ACO or an ACO participant par-26
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63	63	•HR 483 IH
64	64	ticipating in the pilot program shall be exempt from 1
65	65	mandatory eCQM reporting requirements during the 2
66	66	duration of the pilot program. 3
67	67	(3) N
68	68	O EFFECT ON PAYMENT INCENTIVES .— 4
69	69	Participation in the pilot program shall have no ef-5
70	70	fect on the eligibility of an ACO or an ACO partici-6
71	71	pant to qualify for or earn an incentive payment 7
72	72	under section 1833(z) of the Social Security Act (42 8
73	73	U.S.C. 1395l(z)) or a payment adjustment under 9
74	74	section 1848(q) of such Act (42 U.S.C. 1395w– 10
75	75	4(q)). 11
76	76	(4) T
77	77	ECHNICAL ASSISTANCE .—The Secretary 12
78	78	shall provide technical assistance, including waivers 13
79	79	from any applicable quality reporting requirements, 14
80	80	to ACOs and providers participating in the pilot pro-15
81	81	gram to incentivize their participation and to evalu-16
82	82	ate the efficacy of digital reporting methods. 17
83	83	(5) R
84	84	EPORT.—Not later than January 1, 2028, 18
85	85	the Secretary shall submit to Congress a report that 19
86	86	includes— 20
87	87	(A) the findings and results of the pilot 21
88	88	program carried out under paragraph (1); and 22
89	89	(B) any recommendations for increasing 23
90	90	the adoption by additional ACOs of the digital 24
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93	93	•HR 483 IH
94	94	reporting methods tested under such pilot pro-1
95	95	gram. 2
96	96	(c) D
97	97	EVELOPMENT OF LONG-TERMDIGITALQUAL-3
98	98	ITYREPORTINGSTANDARDS.— 4
99	99	(1) I
100	100	N GENERAL.—Not later than January 1, 5
101	101	2030, the Secretary shall implement standards for 6
102	102	digital quality reporting metrics and formats. Such 7
103	103	standards shall ensure that all EHR systems used 8
104	104	by an ACO are capable of supporting digital report-9
105	105	ing methods across a diverse range of practice sizes, 10
106	106	specialties, and geographic locations. 11
107	107	(2) C
108	108	ONSULTATION.—In developing the stand-12
109	109	ards described in paragraph (1), the Secretary shall 13
110	110	collaborate with relevant stakeholders, including rep-14
111	111	resentatives of the National Committee for Quality 15
112	112	Assurance, EHR vendors, ACOs, payers, and na-16
113	113	tional medical and specialty physician groups. 17
114	114	(d) C
115	115	ONTINUEDUSE OFEXISTINGREPORTING 18
116	116	M
117	117	ETHODS.— 19
118	118	(1) I
119	119	N GENERAL.—An ACO or ACO participant 20
120	120	may use the CMS Web Interface portal, MIPS 21
121	121	CQMs, Medicare CQMs, eCQMs, or any other pre-22
122	122	viously established quality reporting methods, for the 23
123	123	purpose of meeting such requirements until the date 24
124	124	on which the Secretary promulgates the standard-25
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127	127	•HR 483 IH
128	128	ized digital quality reporting methods under sub-1
129	129	section (c). 2
130	130	(2) E
131	131	XEMPTION.—No penalties shall be im-3
132	132	posed on ACOs or ACO participants for failure to 4
133	133	comply with eCQM requirements during the period 5
134	134	prior to January 1, 2030, provided they are in com-6
135	135	pliance with existing reporting methods. 7
136	136	(e) D
137	137	EFINITIONS.—In this section: 8
138	138	(1) ACO.—The term ‘‘ACO’’ has the meaning 9
139	139	given the term ‘‘accountable care organization’’ in 10
140	140	section 425.20 of title 42, Code of Federal Regula-11
141	141	tions. 12
142	142	(2) ACO
143	143	PARTICIPANT.—The term ‘‘ACO par-13
144	144	ticipant’’ has the meaning given such term in section 14
145	145	425.20 of title 42, Code of Federal Regulations. 15
146	146	(3) EHR.—The term ‘‘EHR’’ has the meaning 16
147	147	given the term ‘‘certified EHR technology’’ in sec-17
148	148	tion 1848(o) of the Social Security Act (42 U.S.C. 18
149	149	1395w–4(o)). 19
150	150	Æ
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