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Securing Access to Care for Seniors in Critical Condition Act of 2025
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.
Summary
This bill amends Medicare law to establish a new criterion for exempting long-term care hospitals from site-neutral payment policies. The exemption applies to discharges assigned to high-acuity Medicare-Severity-Long-Term-Care-Diagnosis-Related-Groups with a relative weight of 0.8 or higher, beginning October 1, 2026. Long-term care hospitals treating patients meeting this high-acuity criterion will receive Medicare reimbursement at the long-term care hospital rate rather than the lower site-neutral payment rate.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
- Rep. Hern, Kevin [R-OK-1] (R-OK)
8 cosponsors
Actions (2)
- Mar 6, 2025 Referred to the House Committee on Ways and Means. · house
- Mar 6, 2025 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Text versions (1)
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Full text
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.”. <all>
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