Securing Access to Care for Seniors

Summary#

This bill changes a part of the Social Security Act that controls how Medicare pays long-term care hospitals (LTCHs). It adds a new "high acuity" rule. Under the new rule, a hospital discharge will be treated as meeting the high acuity criterion if (1) the discharge is assigned a Medicare-Severity-Long-Term-Care-Diagnosis-Related-Group (MS-LTC-DRG) with a relative weight of 0.8 or higher for that year, and (2) the discharge happens on or after October 1, 2026. The bill also updates an existing list of exceptions so that this new high acuity criterion is included among cases where site-neutral payment rules do not apply to LTCH discharges.

What it means for you#

  • If you are a patient discharged from a long-term care hospital on or after October 1, 2026, and your discharge is assigned an MS-LTC-DRG with a relative weight of 0.8 or higher, this bill creates a rule saying the discharge meets the new "high acuity" criterion.
  • The bill changes when Medicare's site-neutral payment rule does not apply to certain LTCH discharges. It does not itself state how payments will be changed beyond adding the new criterion.

Expenses#

No publicly available information about costs, budget effects, or federal spending is included in the bill text or the provided metadata.

Proponents' View#

Sponsors listed for the bill include Kevin Hern, Brendan Boyle, John Joyce, Carol Miller, Lloyd Smucker, Claudia Tenney, Donald Davis, Mike Carey, Nathaniel Moran, and James Comer. No publicly available information in the bill text or metadata describes proponents' arguments or stated reasons.

Opponents' View#

No publicly available information in the bill text or provided metadata describes opponents' arguments or objections.