119-hr4313

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4313 Reported in House

    (RH) ]

<DOC>

 Union Calendar No. 311
119th CONGRESS
 1st Session
 H. R. 4313

 [Report No. 119-359]

 To amend title XVIII of the Social Security Act to extend acute 
 hospital care at home waiver flexibilities, and to require an 
 additional study and report on such flexibilities.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 July 10, 2025

Mr. Buchanan (for himself, Mr. Smucker, and Mr. Evans of Pennsylvania) 
 introduced the following bill; which was referred to the Committee on 
 Ways and Means

 October 31, 2025

 Additional sponsors: Ms. Tenney, Mr. Carey, Mr. Simpson, Mr. Smith of 
 Nebraska, Mrs. Fischbach, and Mr. Moore of Utah

 October 31, 2025

 Reported with an amendment, committed to the Committee of the Whole 
 House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
 in italic]
 [For text of introduced bill, see copy of bill as introduced on July 
 10, 2025]

_______________________________________________________________________

 A BILL

 To amend title XVIII of the Social Security Act to extend acute 
 hospital care at home waiver flexibilities, and to require an 
 additional study and report on such flexibilities.

 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 ``Hospital Inpatient Services 
Modernization Act''.

SEC. 2. EXTENDING ACUTE HOSPITAL CARE AT HOME WAIVER FLEXIBILITIES.

 

Section 1866G

    (a)

    (1) of the Social Security Act (42 U.S.C. 1395cc-
7

    (a)

    (1) ) is amended by striking ``2025'' and inserting ``2030''.

SEC. 3. REQUIRING ADDITIONAL STUDY AND REPORT ON ACUTE HOSPITAL CARE AT 
 HOME WAIVER FLEXIBILITIES.

 

Section 1866G of the Social Security Act (42 U.S.C. 1395cc-7), as 
amended by 

section 2, is further amended--

    (1) in subsection

    (a)

    (3)
        (E) --
        (A) in clause
            (ii) , by striking ``the study 
 described in subsection

    (b) '' and inserting ``the 
 studies described in subsections

    (b) and
            (c) ''; and
        (B) by adding at the end the following new flush 
 sentence:
 ``The Secretary may require that such data and 
 information be submitted through a hospital's cost 
 report, through such survey instruments as the 
 Secretary may develop, through medical record 
 information, or through such other means as the 
 Secretary determines appropriate.'';

    (2) in subsection

    (b) , in the subsection heading, by 
 striking ``Study'' and inserting ``Initial Study'';

    (3) by redesignating subsections
            (c) and
            (d) as subsections
            (d) and

    (e) , respectively; and

    (4) by inserting after subsection

    (b) the following new 
 subsection:
 ``
            (c) Subsequent Study and Report.--
 ``

    (1) In general.--Not later than September 30, 2028, the 
 Secretary shall conduct a study to--
 ``
        (A) analyze, to the extent practicable, the 
 criteria established by hospitals under the Acute 
 Hospital Care at Home initiative to determine which 
 individuals may be furnished services under such 
 initiative; and
 ``
        (B) analyze and compare (both within and between 
 hospitals participating in the initiative, and relative 
 to comparable hospitals that do not participate in the 
 initiative, for relevant parameters such as diagnosis-
 related groups)--
 ``
            (i) quality of care furnished to 
 individuals with similar conditions and 
 characteristics in the inpatient setting and 
 through the Acute Hospital Care at Home 
 initiative, including health outcomes, hospital 
 readmission rates (including readmissions both 
 within and beyond 30 days post-discharge), 
 hospital mortality rates, length of stay, 
 infection rates, composition of care team 
 (including the types of labor used, such as 
 contracted labor), the ratio of nursing staff, 
 transfers from the hospital to the home, 
 transfers from the home to the hospital 
 (including the timing, frequency, and causes of 
 such transfers), transfers and discharges to 
 post-acute care settings (including the timing, 
 frequency, and causes of such transfers and 
 discharges), and patient and caregiver 
 experience of care;
 ``
            (ii) clinical conditions treated and 
 diagnosis-related groups of discharges from 
 inpatient settings relative to discharges from 
 the Acute Hospital Care at Home initiative;
 ``
            (iii) costs incurred by the hospital for 
 furnishing care in inpatient settings relative 
 to costs incurred by the hospital for 
 furnishing care through the Acute Hospital Care 
 at Home initiative, including costs relating to 
 staffing, equipment, food, prescriptions, and 
 other services, as determined by the Secretary;
 ``
            (iv) the quantity, mix, and intensity of 
 services (such as in-person visits and virtual 
 contacts with patients and the intensity of 
 such services) furnished in inpatient settings 
 relative to the Acute Hospital Care at Home 
 initiative, and, to the extent practicable, the 
 nature and extent of family or caregiver 
 involvement;
 ``
            (v) socioeconomic information on 
 individuals treated in comparable inpatient 
 settings relative to the initiative, including 
 racial and ethnic data, income, housing, 
 geographic proximity to the brick-and-mortar 
 facility and whether such individuals are 
 dually eligible for benefits under this title 
 and title XIX; and
 ``
            (vi) the quality of care, outcomes, 
 costs, quantity and intensity of services, and 
 other relevant metrics between individuals who 
 entered into the Acute Hospital Care at Home 
 initiative directly from an emergency 
 department compared with individuals who 
 entered into the Acute Hospital Care at Home 
 initiative directly from an existing inpatient 
 stay in a hospital.
 ``

    (2) Selection bias.--In conducting the study under 
 paragraph

    (1) , the Secretary shall, to the extent practicable, 
 analyze and compare individuals who participate and do not 
 participate in the initiative controlling for selection bias or 
 other factors that may impact the reliability of data.
 ``

    (3) Report.--Not later than September 30, 2028, the 
 Secretary of Health and Human Services shall submit to the 
 Committee on Ways and Means of the House of Representatives and 
 the Committee on Finance of the Senate a report on the study 
 conducted under paragraph

    (1) .''.
 Union Calendar No. 311

119th CONGRESS

 1st Session

 H. R. 4313

 [Report No. 119-359]

_______________________________________________________________________

 A BILL

 To amend title XVIII of the Social Security Act to extend acute 
 hospital care at home waiver flexibilities, and to require an 
 additional study and report on such flexibilities.

_______________________________________________________________________

 October 31, 2025

 Reported with an amendment, committed to the Committee of the Whole 
 House on the State of the Union, and ordered to be printed