PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the House Committee on Ways and Means.
Congressional Research Service
Version 00 · Introduced in House · Mar 6, 2025
Securing Access to Care for Seniors in Critical Condition Act of 2025
This bill exempts discharges from long-term care hospitals (LTCHs) from the Medicare site-neutral payment rate if the discharge meets specified high acuity criteria and occurs on or after October 1, 2026. (The site-neutral rate is the lower of Medicare’s acute care hospital payment rate under the inpatient prospective payment system or 100% of the cost of the stay. LTCH stays that do not qualify for the specialized LTCH payment rate under Medicare are instead paid at the site-neutral rate.)
People & committees
Rep. Hern, Kevin [R-OK-1] · R–OK
Legislative record
A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.
Referred to the House Committee on Ways and Means.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Sep 15, 2026. Consult Congress.gov for the current record.
AI Conversation Starters
Choose a perspective, copy a prompt, and paste it into your preferred AI. Each prompt includes the bill version and available official source links, and asks for counterarguments as well as supporting evidence.
Analyze H.R.1924 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.
Examine H.R.1924 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.
Examine H.R.1924 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.
Examine H.R.1924 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.
PlainBill explanation
Based on the full Introduced in House · 2025-03-06 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The bill would give long-term care hospitals another way for patient discharges to qualify for an exception to Medicare payment rules called “site-neutral payments.” The proposed exception would depend on the numerical weight assigned to the discharge’s Medicare payment group: it must be at least 0.8 for the relevant fiscal year. It would cover qualifying discharges on or after October 1, 2026.
Establishing a new criterion for the nonapplication of site-neutral payments to long-term care hospitals under the Medicare program
(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.
The proposal would amend the Social Security Act to add a “high acuity” criterion as another alternative for the payment exception, while retaining the reference to the existing ventilator criterion.
Section 1886(m)(6)(A) of the Social Security Act (42 U.S.C. 1395ww(m)(6)(A)) is amended— (1) 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)
The proposed high acuity criterion would require both a qualifying payment-group weight and a qualifying discharge date. A weight of exactly 0.8 would qualify, and the weight would be measured for the fiscal year of the discharge. The provision specifies a starting date of October 1, 2026, without an ending date.
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— (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.
The supplied actions snapshot, updated September 15, 2026, records introduction in the House and referral to the House Committee on Ways and Means on March 6, 2025.
Source snapshot updated 2026-09-15T08:05:32Z. 2025-03-06: Referred to the House Committee on Ways and Means. 2025-03-06: Introduced in House
A closer look
Reviewed version: Introduced in House · 2025-03-06. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy change attached to appropriations was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places was identified in the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
Findings to examine
The proposed payment exception is a targeted exemption central to the bill’s policy. Its classification does not establish its financial value or whether it is justified.
Long-term care hospitals would gain an additional route to exemption from site-neutral payments for discharges assigned a Medicare payment-group weight of at least 0.8 for the relevant fiscal year and occurring on or after October 1, 2026.
Establishing a new criterion for the nonapplication of site-neutral payments to long-term care hospitals under the Medicare program
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— (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.
Full text preserved for this analysis. Legislative record snapshot: Sep 15, 2026. How PlainBill uses AI