H.R. 4313

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4313 Referred in Senate (RFS)]

<DOC>
119th CONGRESS
1st Session
H. R. 4313

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

December 2, 2025

Received; read twice and referred to the Committee on Finance

_______________________________________________________________________

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:

KEVIN F. MCCUMBER,

Clerk.