Technical corrections only. The diff reflects the bill's procedural status change from 'Engrossed in House' to 'Referred in Senate' and includes the clerk's name. No substantive policy changes were made to the bill's text.
Health Care Efficiency Through Flexibility Act
- Sponsor
- Rep. Buchanan, Vern [R-FL-16]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Jul 13, 2026
Bottom line
This bill aims to streamline and modernize quality reporting for Medicare ACOs, potentially reducing administrative burden and encouraging the adoption of digital health technologies, while offsetting its implementation costs from the Medicare Improvement Fund.
What it actually does
The bill amends the Social Security Act to provide Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program with more flexibility in how they report quality measures. It mandates the availability of specific collection types for quality reporting from 2025-2029 and establishes a pilot program for digital quality measure reporting from 2028-2032, allowing participating ACOs to focus on a limited set of digitally reported measures without penalty for others. It also clarifies data completeness requirements and offsets its implementation costs from the Medicare Improvement Fund.
Proponents argue
Supporters argue that the bill reduces the administrative burden on ACOs by offering more flexible and modern quality reporting options, allowing them to focus more on patient care rather than complex data submission. The pilot program is seen as a crucial step towards advancing digital health interoperability and efficiency in Medicare, ultimately improving care quality and reducing costs through better data.
Opponents contend
Critics might argue that by waiving reporting requirements for certain measures in the pilot program and limiting the use of data for performance evaluation, the bill could potentially reduce accountability for ACOs or create gaps in comprehensive quality assessment during the transition. There could also be concerns about the shift of funds from the Medicare Improvement Fund.
The bill is concise and can be read quickly, allowing ample time for stakeholders to understand its provisions.
Section 2(2)(ii)
Required Availability of Quality Measure Collection Types
For performance years 2025 through 2029, the Secretary of Health and Human Services must ensure that Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program have access to specific quality measure collection types: Electronic clinical quality measures, MIPS clinical quality measures, and Medicare Clinical Quality Measures for ACOs. This ensures ACOs have diverse options for submitting their quality data.
Supporters argue
Supporters argue this provision provides necessary flexibility to ACOs, acknowledging the diverse technological capabilities and reporting needs across different organizations. It helps reduce administrative burden by allowing ACOs to choose the most appropriate method for their systems, thereby facilitating more accurate and less burdensome reporting.
Critics contend
No specific opposition is typically raised against this provision, as it generally enhances flexibility for providers without mandating new burdens. Some might argue it doesn't go far enough to simplify reporting, but it's not a point of direct opposition.
Tradeoffs
Balances the need for standardized quality reporting with the practical realities of varied health IT infrastructure among ACOs.
Section 2(2)(iii)
Clarification on Data Completeness for ACO Participants
For performance years starting January 1, 2026, the Secretary cannot deem an ACO's submitted quality data as 'unrepresentative' solely because it excludes data from one or more ACO participants. This exception applies if the ACO otherwise meets data completeness requirements and can demonstrate that the excluded participant was unable to collect the data using the ACO's chosen collection type.
Section 3
Digital Quality Measure Reporting Pilot Program
This section establishes a pilot program for performance years 2028 through 2032, where selected ACOs will report two specified quality measures using a digital collection type. Crucially, participating ACOs will not be required to report other quality measures and the data from the pilot (or waived measures) will not be used to determine their quality performance standards or MIPS scores for their participants. The Secretary will provide technical assistance and publicly report an analysis and recommendations by December 31, 2032.
This section reduces the appropriation to the Medicare Improvement Fund by $8,000,000, effectively offsetting the $8,000,000 appropriated for the implementation of this Act.
Section 4(b)
Why it matters:This is standard legislative practice for budget neutrality, ensuring that new spending is offset by reductions elsewhere, often in existing funds. It's not necessarily evasive but requires familiarity with federal budgeting.
Case for: Supporters would argue this demonstrates fiscal responsibility by ensuring the bill's implementation costs are fully offset, preventing an increase in the federal deficit.
Case against: Critics might argue that reducing the Medicare Improvement Fund, which is used for various Medicare program improvements, could divert resources from other beneficial initiatives, even if the amount is relatively small.
Estimated impact: Reduces the Medicare Improvement Fund by $8,000,000.