119-hr5347

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5347 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 5347

 To amend title XVIII of the Social Security Act to ensure the 
 availability of appropriate collection types for quality reporting 
 under the Medicare Shared Savings Program, and for other purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 September 15, 2025

 Mr. Buchanan (for himself, Mr. Panetta, Mr. Crenshaw, and Mr. LaHood) 
 introduced the following bill; which was referred to the Committee on 
 Ways and Means, and in addition to the Committee on Energy and 
Commerce, 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 committee concerned

_______________________________________________________________________

 A BILL

 To amend title XVIII of the Social Security Act to ensure the 
 availability of appropriate collection types for quality reporting 
 under the Medicare Shared Savings Program, and for other purposes.

 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 ``Health Care Efficiency Through 
Flexibility Act''.

SEC. 2. ENSURING AVAILABILITY OF APPROPRIATE COLLECTION TYPES FOR 
 QUALITY REPORTING UNDER THE MEDICARE SHARED SAVINGS 
 PROGRAM.

 

Section 1899

    (b)

    (3)
        (B) of the Social Security Act (42 U.S.C. 
1395jjj

    (b)

    (3)
        (B) ) is amended--

    (1) by striking ``An ACO shall submit'' and inserting the 
 following:
 ``
            (i) In general.--An ACO shall submit''; 
 and

    (2) by adding at the end the following new clauses:
 ``
            (ii) Required availability of collection 
 types for certain years.--For performance years 
 2025 through 2029, the Secretary shall ensure 
 that the following collection types (as 
 described in 

section 414.1305 of title 42, Code 
 of Federal Regulations (or a successor 
 regulation)) are available with respect to each 
 measure described in subparagraph
        (A)
            (i) required to be reported by an ACO under this 
 paragraph:
 ``
            (I) Electronic clinical quality 
 measures.
 ``
            (II) MIPS clinical quality 
 measures.
 ``
            (III) Medicare Clinical Quality 
 Measures for Accountable Care 
 Organizations Participating in the 
 Medicare Shared Savings Program.
 ``
            (iii) Clarification on application of 
 data completeness requirements in certain 
 cases.--
 ``
            (I) In general.--In determining 
 whether data submitted by an ACO with 
 respect to a measure described in 
 subparagraph
        (A)
            (i) for a performance 
 year beginning on or after January 1, 
 2025, satisfies the data completeness 
 requirements applicable to such measure 
 under 

section 414.1340 of title 42, 
 Code of Federal Regulations (or a 
 successor regulation) (as applied 
 pursuant to 

section 425.512 of title 
 42, Code of Federal Regulations (or a 
 successor regulation)), the Secretary 
 may not find such data to be 
 unrepresentative of such ACO's 
 performance for such year (as described 
 in paragraph

    (e) of such 

section 414.1340) based solely on the fact that 
 such data excludes applicable data from 
 1 or more ACO participants in such ACO 
 if--
 ``

    (aa) such data submitted 
 by the ACO otherwise complies 
 with the data completeness 
 requirements of such 

section 414.1340; and
 ``

    (bb) such ACO 
 demonstrates to the 
 satisfaction of the Secretary 
 that such ACO participant was 
 unable to collect such data 
 through the collection type (as 
 described in clause
            (ii) ) 
 selected by the ACO for the 
 submission of such data.
 ``
            (II) === Definition. ===
-In this clause, 
 the term `ACO participant' has the 
 meaning given such term in 

section 425.20 of title 42, Code of Federal 
 Regulations (or a successor 
 regulation).
 ``
            (III) Implementation.--The 
 Secretary may implement this clause by 
 program instruction or otherwise.''.

SEC. 3. PILOT PROGRAM FOR DIGITAL QUALITY MEASURE REPORTING.

 

Section 1899

    (b)

    (3)
        (B) of the Social Security Act (42 U.S.C. 
1395jjj

    (b)

    (3)
        (B) ), as amended by 

section 2, is further amended by 
adding at the end the following new clause:
 ``
            (iv) Pilot program for digital quality 
 measure reporting.--
 ``
            (I) In general.--For each of 
 performance years 2028 through 2032, 
 the Secretary shall establish a digital 
 quality measure reporting pilot program 
 (in this clause referred to as the 
 `program') under which ACOs selected 
 under subclause
            (II) for such 
 performance year report quality 
 measures specified by the Secretary 
 under subclause
            (III) for such 
 performance year through a digital 
 quality measure collection type 
 specified by the Secretary.
 ``
            (II) Selection.--The Secretary 
 shall select ACOs to participate in the 
 program for a performance year from 
 among ACOs that submit an application 
 at such time and in such form and 
 manner as specified by the Secretary.
 ``
            (III) Specification of quality 
 measures.--For each performance year of 
 the program, the Secretary shall 
 specify 2 measures described in 
 subparagraph
        (A)
            (i) otherwise required 
 to be reported by ACOs for such 
 performance year for which an ACO 
 selected under subclause
            (II) shall 
 submit data through the collection type 
 specified in subclause
            (I) .
 ``
            (IV) Waiver of requirement to 
 report other measures.--The Secretary 
 may not require an ACO selected under 
 subclause
            (II) for a performance year 
 to report data on any measure described 
 in subparagraph
        (A) otherwise required 
 to be reported by an ACO under this 
 paragraph for such performance year, 
 other than such a measure specified 
 under subclause
            (III) for such 
 performance year.
 ``
            (V) Disregard of data for certain 
 measures.--The Secretary may not take 
 into account any data for a measure 
 specified under subclause
            (III) for a 
 performance year submitted by an ACO 
 selected under subclause
            (II) for such 
 performance year, or any data for a 
 measure with respect to which such ACO 
 is not required to report data for such 
 performance year under subclause
            (IV) , 
 in determining--
 ``

    (aa) whether such ACO has 
 met quality performance 
 standards established by the 
 Secretary under subparagraph
            (C) for such performance year; 
 or
 ``

    (bb) any score for the 
 quality performance category 
 (as described in 

section 1848

    (q)

    (2)
        (A)
            (i) ) for an ACO 
 participant (as defined in 
 clause
            (iii) 
            (II) ) in such ACO 
 for such performance year.
 ``
            (VI) Technical assistance.--The 
 Secretary shall provide such technical 
 assistance to ACOs selected to 
 participate in the program as is 
 practicable.
 ``
            (VII) Provision of information.--
 Not later than December 31, 2032, the 
 Secretary shall publicly post (or 
 include as part of annual rulemaking 
 for this section) the following:
 ``

    (aa) An analysis of the 
 program.
 ``

    (bb) Any recommendations 
 for increasing submissions of 
 data for measures described in 
 subparagraph
        (A)
            (i) through the 
 collection type specified in 
 subclause
            (I) .
 ``
            (cc) A proposed timeline 
 for requiring such measures to 
 be submitted through such 
 collection type.''.
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