[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4313 Engrossed in House (EH)]
<DOC>
119th CONGRESS
1st Session
H. R. 4313
_______________________________________________________________________
AN ACT
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 ``January 30, 2026'' and inserting
``September 30, 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)--
(A) in the subsection heading, by striking
``Study'' and inserting ``Initial Study''; and
(B) in paragraph (3), by inserting ``or subsection
(c)'' before the period at the end;
(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).
``(4) Funding.--In addition to amounts otherwise available,
there is appropriated to the Centers for Medicare & Medicaid
Services Program Management Account for fiscal year 2026, out
of any amounts in the Treasury not otherwise appropriated,
$2,500,000, to remain available until expended, for purposes of
carrying out this subsection.''.
SEC. 4. MEDICARE IMPROVEMENT FUND.
Section 1898(b)(1) of the Social Security Act (42 U.S.C.
1395iii(b)(1)) is amended by striking ``$1,403,000,000'' and inserting
``$1,400,500,000''.
Passed the House of Representatives December 1, 2025.
Attest:
Clerk.
119th CONGRESS
1st Session
H. R. 4313
_______________________________________________________________________
AN ACT
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.