H.R. 9468

119 HR 9468 IH: Saving Today’s Acute-Care Resources Act
 U.S. House of Representatives
 2026-06-25
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 I  119th CONGRESS  2d Session  H. R. 9468  IN THE HOUSE OF REPRESENTATIVES   June 25, 2026   Mr. Hern of Oklahoma  (for himself,  Mrs. Miller of West Virginia , and  Mr. Smucker ) introduced the following bill; which was referred to the  Committee on Ways and Means    A BILL
To amend title XVIII of the Social Security Act to adjust long-term care hospital payment rates under the Medicare program.
1.
Short title
This Act may be cited as the   Saving Today’s Acute-Care Resources Act   or the   STAR Act  .
2.
Adjusting long-term care hospital payment rates under the Medicare program
(a)
Extension of site neutral payment reductions
Section 1886(m)(6)(B)(iv) of the Social Security Act ( 42 U.S.C. 1395ww(m)(6)(B)(iv) ) is amended by striking  2026  and inserting  2032 .
(b)
Modification of criteria for nonapplication of site neutral payment rate
(1)
Addition of high acuity criterion
Section 1886(m)(6)(A) of the Social Security Act ( 42 U.S.C. 1395ww(m)(6)(A) ) is amended—
(A)
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) ; and
(B)
by adding at the end the following new clause:
(v)
High acuity criterion
(I)
In general
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—
(aa)
the stay in the long-term care hospital ending with such discharge was immediately preceded by a discharge from a stay in a subsection (d) hospital or a stay in a critical access hospital;
(bb)
the individual discharged was assigned to a Medicare-Severity-Long-Term-Care-Diagnosis-Related-Group (MS-LTC-DRG) that was a specified MS-LTC-DRG (as described in  subclause (II) ) with respect to such fiscal year;
(cc)
the discharge was from a long-term care hospital—
(AA)
that enrolled under this title as such a hospital before the date of the enactment of this clause;
(BB)
whose qualifying period (as described in section 412.23(e)(4)(iv) of title 42, Code of Federal Regulations (or a successor regulation)) began before such date;
(CC)
that met the mid-build requirements described in  subclause (III) ; or
(DD)
that had obtained an approved certificate of need from the State in which such hospital is located before such date, if required by State law; and
(dd)
the discharge occurred on or after October 1, 2026.
(II)
Specified MS-LTC-DRG defined
For purposes of subclause  subclause (I)(bb) , the term  specified MS-LTC-DRG  means, with respect to a fiscal year, an MS-LTC-DRG—
(aa)
with a relative weight of 0.8 or greater; and
(bb)
that is not assigned on the basis of the receipt of ventilator services of at least 96 hours.
(III)
Mid-build requirements described
For purposes of  subclause (I)(cc) , the mid-build requirements described in this clause are, with respect to a long-term care hospital, that—
(aa)
such hospital had a binding written agreement with an outside, unrelated party for the actual construction, renovation, lease, or demolition of such hospital in effect as of the date of the enactment of this clause and, prior to such date, had expended at least 10 percent (or, if less, $2,500,000) of the estimated cost of such construction, renovation, lease, or demolition; and
(bb)
the Secretary receives, not later than 60 days after such date, from the chief executive officer or chief operating officer of such hospital a written certification that the hospital met the requirement under  item (aa) .
  .
(2)
Modification of ICU and ventilator criteria
Section 1886(m)(6)(A) of the Social Security Act ( 42 U.S.C. 1395ww(m)(6)(A) ) is amended—
(A)
in clause (iii)(I), by inserting  or, with respect to discharges from a long-term care hospital occurring on or after October 1, 2026, by a discharge from a stay in such a hospital or a stay in a critical access hospital,  after  in a subsection (d) hospital ; and
(B)
in clause (iv)(I), by inserting  or, with respect to discharges from a long-term care hospital occurring on or after October 1, 2026, by a discharge from a stay in such a hospital or a stay in a critical access hospital  after  in a subsection (d) hospital .