Full Text
Official text as published. Use Ctrl+F / Cmd+F to search within the document.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9468 Introduced in House (IH)]
<DOC>
119th CONGRESS
2d Session
H. R. 9468
To amend title XVIII of the Social Security Act to adjust long-term
care hospital payment rates under the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 25, 2026
Mr. Hern of Oklahoma (for himself, Mrs. Miller of West Virginia, and
Mr. Smucker) introduced the following bill; which was referred to the
Committee on Ways and Means
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to adjust long-term
care hospital payment rates under the Medicare program.
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 ``Saving Today's Acute-Care Resources
Act'' or the ``STAR Act''.
SEC. 2. ADJUSTING LONG-TERM CARE HOSPITAL PAYMENT RATES UNDER THE
MEDICARE PROGRAM.
(a) Extension of Site Neutral Payment Reductions.--Section
1886(m)(6)(B)(iv) of the Social Security Act (42 U.S.C.
1395ww(m)(6)(B)(iv)) is amended by striking ``2026'' and inserting
``2032''.
(b) Modification of Criteria for Nonapplication of Site Neutral
Payment Rate.--
(1) Addition of high acuity criterion.--Section
1886(m)(6)(A) of the Social Security Act (42 U.S.C.
1395ww(m)(6)(A)) is amended--
(A) 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
(B) by adding at the end the following new clause:
``(v) High acuity criterion.--
``(I) In general.--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--
``(aa) the stay in the
long-term care hospital ending
with such discharge was
immediately preceded by a
discharge from a stay in a
subsection (d) hospital or a
stay in a critical access
hospital;
``(bb) the individual
discharged was assigned to a
Medicare-Severity-Long-Term-
Care-Diagnosis-Related-Group
(MS-LTC-DRG) that was a
specified MS-LTC-DRG (as
described in subclause (II))
with respect to such fiscal
year;
``(cc) the discharge was
from a long-term care
hospital--
``(AA) that
enrolled under this
title as such a
hospital before the
date of the enactment
of this clause;
``(BB) whose
qualifying period (as
described in section
412.23(e)(4)(iv) of
title 42, Code of
Federal Regulations (or
a successor
regulation)) began
before such date;
``(CC) that met the
mid-build requirements
described in subclause
(III); or
``(DD) that had
obtained an approved
certificate of need
from the State in which
such hospital is
located before such
date, if required by
State law; and
``(dd) the discharge
occurred on or after October 1,
2026.
``(II) Specified ms-ltc-drg
defined.--For purposes of subclause
subclause (I)(bb), the term `specified
MS-LTC-DRG' means, with respect to a
fiscal year, an MS-LTC-DRG--
``(aa) with a relative
weight of 0.8 or greater; and
``(bb) that is not assigned
on the basis of the receipt of
ventilator services of at least
96 hours.
``(III) Mid-build requirements
described.--For purposes of subclause
(I)(cc), the mid-build requirements
described in this clause are, with
respect to a long-term care hospital,
that--
``(aa) such hospital had a
binding written agreement with
an outside, unrelated party for
the actual construction,
renovation, lease, or
demolition of such hospital in
effect as of the date of the
enactment of this clause and,
prior to such date, had
expended at least 10 percent
(or, if less, $2,500,000) of
the estimated cost of such
construction, renovation,
lease, or demolition; and
``(bb) the Secretary
receives, not later than 60
days after such date, from the
chief executive officer or
chief operating officer of such
hospital a written
certification that the hospital
met the requirement under item
(aa).''.
(2) Modification of icu and ventilator criteria.--Section
1886(m)(6)(A) of the Social Security Act (42 U.S.C.
1395ww(m)(6)(A)) is amended--
(A) in clause (iii)(I), by inserting ``or, with
respect to discharges from a long-term care hospital
occurring on or after October 1, 2026, by a discharge
from a stay in such a hospital or a stay in a critical
access hospital,'' after ``in a subsection (d)
hospital''; and
(B) in clause (iv)(I), by inserting ``or, with
respect to discharges from a long-term care hospital
occurring on or after October 1, 2026, by a discharge
from a stay in such a hospital or a stay in a critical
access hospital'' after ``in a subsection (d)
hospital''.
<all>