Securing Access to Care for Seniors in Critical Condition Act of 2025
Summary
HB1924, the Securing Access to Care for Seniors in Critical Condition Act of 2025, would amend Medicare payment rules for long-term care hospitals (LTCHs). The bill creates a new “high acuity criterion” that would allow certain LTCH discharges to remain exempt from site-neutral payment reductions if the discharge is assigned to an MS-LTC-DRG with a relative weight of at least 0.8 and occurs on or after October 1, 2026. In practical terms, the bill expands the circumstances under which LTCHs can receive higher Medicare payments rather than being paid under site-neutral rates.
The legislation would modify section 1886(m)(6)(A) of the Social Security Act, which governs when site-neutral payments do not apply to LTCHs under Medicare. By adding the high acuity criterion alongside existing exceptions, the bill would affect how Medicare reimburses hospitals that treat medically complex patients requiring extended inpatient care. The change is prospective, with the new criterion tied to discharges beginning in fiscal year 2027 (after October 1, 2026).
Impact
If enacted, the bill would alter Medicare reimbursement policy for long-term care hospitals by broadening the statutory exceptions to site-neutral payment reductions. This would likely increase the number of LTCH cases eligible for higher, facility-specific payment rates, affecting federal Medicare spending, LTCH revenue, and payment determinations for patients with higher-acuity diagnoses. The bill amends the Social Security Act and would directly affect CMS administration of LTCH payment rules.
Sentiment
Based on the bill’s title, bipartisan sponsorship, and lack of recorded committee debate or votes in the provided materials, the overall sentiment appears generally supportive and policy-focused. The sponsors frame the measure as protecting access to care for seniors in critical condition, suggesting an intent to preserve specialized hospital capacity for medically complex patients. No opposition is documented in the available context.
Contention
The main policy issue is whether expanding exceptions to site-neutral payments is appropriate. Supporters are likely to argue that high-acuity LTCH patients need specialized care and that current payment rules may undercompensate hospitals treating the sickest beneficiaries. Potential critics may contend that the bill weakens site-neutral payment reforms, could raise Medicare costs, and may favor LTCH providers over broader payment efficiency goals. No specific objections or amendments are recorded in the provided committee materials.