Health Care Efficiency Through Flexibility Act

Text in the Record

Mr. SMITH of Missouri. Mr. Speaker, I move to suspend the rules and pass the bill (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, as amended. The Clerk read the title of the bill. The text of the bill is as follows:

H.R. 5347

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, 2026, 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.''.

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