Medicare's Accountable Care Organizations (ACOs) earn bonus payments partly by reporting quality measures — data showing how well they coordinate care for patients. A 2024 rule threatened to require all ACOs to shift to a single electronic format (eCQMs) that not all providers' systems can support. This bill amends the Social Security Act to guarantee ACOs can choose from three accepted reporting formats through 2029: electronic Clinical Quality Metrics, MIPS clinical quality measures, or Medicare CQMs designed specifically for ACOs. It also prevents the government from penalizing an ACO for incomplete data when a participating provider genuinely could not collect it using the ACO's chosen format. A voluntary pilot program running from 2028 to 2032 will test fully digital quality reporting on two specified measures per year, with public findings and a proposed rollout timeline to be released by December 2032.
Congressional Summary
Health Care Efficiency Through Flexibility ActThis bill delays certain requirements relating to the reporting of quality measures by accountable care organizations (ACOs) under the Medicare Shared Savings Program. It also requires the Centers for Medicare & Medicaid Services (CMS) to establish a pilot program that tests alternative digital reporting methods for ACOs.The Medicare Shared Savings Program enables ACOs to receive payments for savings stemming from care coordination and management. In 2024, the CMS issued a rule requiring ACOs to report on quality measures using a certain electronic system beginning in 2025. The bill allows ACOs to continue to use prior methods of reporting quality measures through 2029. Additionally, the CMS must establish a pilot program to test other digital reporting methods from 2028-2032; ACOs that participate in the pilot program are exempt from using other methods. The CMS must publicly post an analysis of the program and any related recommendations for using the tested methods.
Legislative Subjects
Details
- Congress
- 119th
- Chamber
- House
- Status
- summarized
- Action
- Introduced in House
- Action Date
- 2025-09-15
- Date Added
- 2026-06-25
- Source
- Congress.gov →
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