ACO Assignment Improvement Act of 2025

ACO Assignment Improvement Act of 2025

This bill establishes additional requirements for assigning Medicare fee-for-service beneficiaries to accountable care organizations (ACOs) under the Medicare shared savings program. Under current law, the program enables ACOs to receive payments for savings stemming from care coordination and management.

The bill requires the basis for assignment to reflect beneficiaries' utilization of not only primary care services provided by ACO physicians, but also those provided by other ACO practitioners—specifically, physician assistants, nurse practitioners, and clinical nurse specialists.

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4773 Introduced in House (IH)]

<DOC>






119th CONGRESS
  1st Session
                                H. R. 4773

 To amend title XVIII of the Social Security Act to establish a SNF-at-
                home program under the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 25, 2025

  Mr. Smith of Nebraska (for himself and Ms. DelBene) introduced the 
following bill; which was referred to the Committee on Ways and Means, 
 and in addition to the Committee on Energy and Commerce, 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

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to establish a SNF-at-
                home program 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 ``ACO Assignment Improvement Act of 
2025''.

SEC. 2. IMPROVEMENTS TO THE ASSIGNMENT OF BENEFICIARIES UNDER THE 
              MEDICARE SHARED SAVINGS PROGRAM.

    Section 1899(c)(1) of the Social Security Act (42 U.S.C. 
1395jjj(c)(1)) is amended--
            (1) in subparagraph (A), by striking ``and'' at the end;
            (2) in subparagraph (B), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(C) in the case of performance years beginning on 
                or after January 1, 2027, primary care services 
                provided under this title by an ACO professional 
                described in subsection (h)(1)(B)''.
                                 <all>