HR1924-119

1. Short title This Act may be cited as the Securing Access to Care for Seniors in Critical Condition Act of 2025.

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— 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 by adding at the end the following new clause: 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— 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 the discharge occurred on or after October 1, 2026. (v)High acuity criterionThe 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..