January 16, 2025
Mr. Buchanan (for himself, Mr. Panetta, and Mr. Crenshaw) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
To direct the Secretary of Health and Human Services to delay the implementation of electronic clinical quality metrics for accountable care organizations, and for other purposes.
Section 1. Short title
This Act may be cited as the Health Care Efficiency Through Flexibility Act
.
Sec. 2. Delay in implementation of eCQMs for ACOs
(a) Delay of eCQM implementation
The Secretary of Health and Human Services (in this section referred to as the Secretary
) shall delay the implementation of the requirement for ACOs to transition from reporting quality measures via the Centers for Medicare & Medicare Services Web Interface portal to electronic Clinical Quality Metrics (eCQMs), as described in the rule titled Medicare and Medicaid Programs; CY 2025 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments
(89 Fed. Reg. 97710 (December 9, 2024)), until January 1, 2030.
(b) Pilot program for digital reporting methods
(1) In general
Not later than January 1, 2026, the Secretary shall establish and commence a pilot program to test digital reporting methods for quality measures on a subset of ACOs and ACO participants that submit an application to participate in such pilot program at such time and in such form as the Secretary determines appropriate.
(2) Temporary exemption from eCQM requirements
An ACO or an ACO participant participating in the pilot program shall be exempt from mandatory eCQM reporting requirements during the duration of the pilot program.
(3) No effect on payment incentives
Participation in the pilot program shall have no effect on the eligibility of an ACO or an ACO participant to qualify for or earn an incentive payment under section 1833(z) of the Social Security Act (42 U.S.C. 1395l(z)) or a payment adjustment under section 1848(q) of such Act (42 U.S.C. 1395w–4(q)).
(4) Technical assistance
The Secretary shall provide technical assistance, including waivers from any applicable quality reporting requirements, to ACOs and providers participating in the pilot program to incentivize their participation and to evaluate the efficacy of digital reporting methods.
(5) Report
Not later than January 1, 2028, the Secretary shall submit to Congress a report that includes—
(A)
the findings and results of the pilot program carried out under paragraph (1); and
(B)
any recommendations for increasing the adoption by additional ACOs of the digital reporting methods tested under such pilot program.
(c) Development of long-Term digital quality reporting standards
(1) In general
Not later than January 1, 2030, the Secretary shall implement standards for digital quality reporting metrics and formats. Such standards shall ensure that all EHR systems used by an ACO are capable of supporting digital reporting methods across a diverse range of practice sizes, specialties, and geographic locations.
(2) Consultation
In developing the standards described in paragraph (1), the Secretary shall collaborate with relevant stakeholders, including representatives of the National Committee for Quality Assurance, EHR vendors, ACOs, payers, and national medical and specialty physician groups.
(d) Continued use of existing reporting methods
(1) In general
An ACO or ACO participant may use the CMS Web Interface portal, MIPS CQMs, Medicare CQMs, eCQMs, or any other previously established quality reporting methods, for the purpose of meeting such requirements until the date on which the Secretary promulgates the standardized digital quality reporting methods under subsection (c).
(2) Exemption
No penalties shall be imposed on ACOs or ACO participants for failure to comply with eCQM requirements during the period prior to January 1, 2030, provided they are in compliance with existing reporting methods.
(e) Definitions
In this section:
(1) ACO
The term ACO has the meaning given the term accountable care organization in section 425.20 of title 42, Code of Federal Regulations.
(2) ACO participant
The term ACO participant has the meaning given such term in section 425.20 of title 42, Code of Federal Regulations.
(3) EHR
The term EHR has the meaning given the term certified EHR technology in section 1848(o) of the Social Security Act (42 U.S.C. 1395w–4(o)).