119-hr1924

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1924 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 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 hospitals under the Medicare program.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 March 6, 2025

Mr. Hern of Oklahoma (for himself, Mr. Boyle of Pennsylvania, Mr. Joyce 
 of Pennsylvania, Mrs. Miller of West Virginia, Mr. Smucker, and Ms. 
 Tenney) introduced the following bill; which was referred to the 
 Committee 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 Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Securing Access to Care for Seniors 
in Critical Condition Act of 2025''.

SEC. 2. ESTABLISHING A NEW CRITERION FOR THE NONAPPLICATION OF SITE-
 NEUTRAL PAYMENTS TO LONG-TERM CARE HOSPITALS UNDER THE 
 MEDICARE PROGRAM.

 

Section 1886
            (m) (6)
        (A) of the Social Security Act (42 U.S.C. 
1395ww
            (m) (6)
        (A) ) is amended--

    (1) in clause
            (ii) 
            (I) , by striking ``or the ventilator 
 criterion under clause
            (iv) '' and inserting ``, the ventilator 
 criterion under clause
            (iv) , or the high acuity criterion 
 described in clause
            (v) ''; and

    (2) by adding at the end the following new clause:
 ``
            (v) High acuity criterion.--The criterion 
 specified in this clause (in this paragraph 
 referred to as the `high acuity criterion') for 
 a discharge from a long-term care hospital in a 
 fiscal year is that--
 ``
            (I) the discharge was assigned to 
 a Medicare-Severity-Long-Term-Care-
 Diagnosis-Related-Group (MS-LTC-DRG) 
 with a relative weight for such fiscal 
 year that was equal to or greater than 
 0.8; and
 ``
            (II) the discharge occurred on or 
 after October 1, 2026.''.
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