H.R. 5347

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5347 Referred in Senate (RFS)]

<DOC>
119th CONGRESS
2d Session
H. R. 5347

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

July 13, 2026

Received; read twice and referred to the Committee on Finance

_______________________________________________________________________

AN ACT

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.

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.''.

SEC. 3. PILOT PROGRAM FOR DIGITAL QUALITY MEASURE REPORTING.

Section 1899(b)(3)(B) of the Social Security Act (42 U.S.C. 
1395jjj(b)(3)(B)), as amended by section 2, is further amended by 
adding at the end the following new clause:
``(iv) Pilot program for digital quality 
measure reporting.--
``(I) In general.--For each of 
performance years 2028 through 2032, 
the Secretary shall establish a digital 
quality measure reporting pilot program 
(in this clause referred to as the 
`program') under which ACOs selected 
under subclause (II) for such 
performance year report quality 
measures specified by the Secretary 
under subclause (III) for such 
performance year through a digital 
quality measure (as defined by the 
Secretary) collection type specified by 
the Secretary.
``(II) Selection.--The Secretary 
shall select ACOs to participate in the 
program for a performance year from 
ACOs that submit an application at such 
time and in such form and manner as 
specified by the Secretary.
``(III) Specification of quality 
measures.--For each performance year of 
the program, the Secretary shall 
specify 2 measures described in 
subparagraph (A)(i) otherwise required 
to be reported by ACOs for such 
performance year for which an ACO 
selected under subclause (II) shall 
submit data through the collection type 
specified in subclause (I).
``(IV) Waiver of requirement to 
report other measures.--The Secretary 
may not require an ACO selected under 
subclause (II) for a performance year 
to report data on any measure described 
in subparagraph (A)(i) otherwise 
required to be reported by an ACO under 
this paragraph for such performance 
year, other than such a measure 
specified under subclause (III) for 
such performance year.
``(V) Disregard of data for certain 
measures.--The Secretary may not take 
into account any data for a measure 
specified under subclause (III) for a 
performance year submitted by an ACO 
selected under subclause (II) for such 
performance year, or any data for a 
measure with respect to which such ACO 
is not required to report data for such 
performance year under subclause (IV), 
in determining--
``(aa) whether such ACO has 
met quality performance 
standards established by the 
Secretary under subparagraph 
(C) for such performance year; 
or
``(bb) any score for the 
quality performance category 
(as described in section 
1848(q)(2)(A)(i)) for an ACO 
participant (as defined in 
clause (iii)(II)) in such ACO 
for such performance year.
``(VI) Technical assistance.--The 
Secretary shall provide such technical 
assistance to ACOs selected to 
participate in the program as is 
practicable.
``(VII) Provision of information.--
Not later than December 31, 2032, the 
Secretary shall publicly post (or 
include as part of annual rulemaking 
for this section) the following:
``(aa) An analysis of the 
program.
``(bb) Any recommendations 
for increasing submissions of 
data for measures described in 
subparagraph (A)(i) through the 
collection type specified in 
subclause (I); and
``(cc) A proposed timeline 
for requiring such measures to 
be submitted through such 
collection type.''.

SEC. 4. IMPLEMENTATION FUNDING.

(a) In General.--There are appropriated, out of any funds in the 
Treasury not otherwise obligated, $8,000,000 for fiscal year 2026, to 
remain available until expended, to the Centers for Medicare & Medicaid 
Services Program Management Account for purposes of implementing the 
amendments made by sections 2 and 3.
(b) Medicare Improvement Fund.--Section 1898(b)(1) of the Social 
Security Act (42 U.S.C. 1395iii(b)(1)) is amended by striking 
``$2,062,000,000'' and inserting ``$2,054,000,000''.

Passed the House of Representatives June 29, 2026.

Attest:

KEVIN F. MCCUMBER,

Clerk.