119TH CONGRESS 
1ST SESSION H. R. 4313 
AN ACT 
To amend title XVIII of the Social Security Act to extend 
acute hospital care at home waiver flexibilities, and to 
require an additional study and report on such flexibili-
ties. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Hospital Inpatient 
Services Modernization Act’’. 
SEC. 2. EXTENDING ACUTE HOSPITAL CARE AT HOME 
WAIVER FLEXIBILITIES. 
Section 1866G(a)(1) of the Social Security Act (42 
U.S.C. 1395cc–7(a)(1)) is amended by striking ‘‘January 
30, 2026’’ and inserting ‘‘September 30, 2030’’. 
SEC. 3. REQUIRING ADDITIONAL STUDY AND REPORT ON 
ACUTE HOSPITAL CARE AT HOME WAIVER 
FLEXIBILITIES. 
Section 1866G of the Social Security Act (42 U.S.C. 
1395cc–7), as amended by section 2, is further amended— 
(1) in subsection (a)(3)(E)— 
(A) in clause (ii), by striking ‘‘the study 
described in subsection (b)’’ and inserting ‘‘the 
studies described in subsections (b) and (c)’’; 
and 
(B) by adding at the end the following new 
flush sentence: 
‘‘The Secretary may require that such data and 
information be submitted through a hospital’s 
cost report, through such survey instruments as 
the Secretary may develop, through medical 
record information, or through such other
means as the Secretary determines appro-
priate.’’; 
(2) in subsection (b)— 
(A) in the subsection heading, by striking 
‘‘STUDY’’ and inserting ‘‘INITIAL STUDY’’; and 
(B) in paragraph (3), by inserting ‘‘or sub-
section (c)’’ before the period at the end; 
(3) by redesignating subsections (c) and (d) as 
subsections (d) and (e), respectively; and 
(4) by inserting after subsection (b) the fol-
lowing new subsection: 
‘‘(c) SUBSEQUENT STUDY AND REPORT.— 
‘‘(1) IN GENERAL.—Not later than September 
30, 2028, the Secretary shall conduct a study to— 
‘‘(A) analyze, to the extent practicable, the 
criteria established by hospitals under the Acute 
Hospital Care at Home initiative to determine 
which individuals may be furnished services 
under such initiative; and 
‘‘(B) analyze and compare (both within 
and between hospitals participating in the ini-
tiative, and relative to comparable hospitals 
that do not participate in the initiative, for rel-
evant parameters such as diagnosis-related 
groups)—
‘‘(i) quality of care furnished to indi-
viduals with similar conditions and charac-
teristics in the inpatient setting and 
through the Acute Hospital Care at Home 
initiative, including health outcomes, hos-
pital readmission rates (including readmis-
sions both within and beyond 30 days post- 
discharge), hospital mortality rates, length 
of stay, infection rates, composition of care 
team (including the types of labor used, 
such as contracted labor), the ratio of 
nursing staff, transfers from the hospital 
to the home, transfers from the home to 
the hospital (including the timing, fre-
quency, and causes of such transfers), 
transfers and discharges to post-acute care 
settings (including the timing, frequency, 
and causes of such transfers and dis-
charges), and patient and caregiver experi-
ence of care; 
‘‘(ii) clinical conditions treated and di-
agnosis-related groups of discharges from 
inpatient settings relative to discharges 
from the Acute Hospital Care at Home ini-
tiative;
‘‘(iii) costs incurred by the hospital 
for furnishing care in inpatient settings 
relative to costs incurred by the hospital 
for furnishing care through the Acute Hos-
pital Care at Home initiative, including 
costs relating to staffing, equipment, food, 
prescriptions, and other services, as deter-
mined by the Secretary; 
‘‘(iv) the quantity, mix, and intensity 
of services (such as in-person visits and 
virtual contacts with patients and the in-
tensity of such services) furnished in inpa-
tient settings relative to the Acute Hospital 
Care at Home initiative, and, to the extent 
practicable, the nature and extent of family 
or caregiver involvement; 
‘‘(v) socioeconomic information on in-
dividuals treated in comparable inpatient 
settings relative to the initiative, including 
racial and ethnic data, income, housing, 
geographic proximity to the brick-and-mor-
tar facility and whether such individuals 
are dually eligible for benefits under this 
title and title XIX; and
‘‘(vi) the quality of care, outcomes, 
costs, quantity and intensity of services, 
and other relevant metrics between individ-
uals who entered into the Acute Hospital 
Care at Home initiative directly from an 
emergency department compared with indi-
viduals who entered into the Acute Hos-
pital Care at Home initiative directly from 
an existing inpatient stay in a hospital. 
‘‘(2) SELECTION
BIAS.—In conducting the 
study under paragraph (1), the Secretary shall, to 
the extent practicable, analyze and compare individ-
uals who participate and do not participate in the 
initiative controlling for selection bias or other fac-
tors that may impact the reliability of data. 
‘‘(3) REPORT.—Not later than September 30, 
2028, the Secretary of Health and Human Services 
shall submit to the Committee on Ways and Means 
of the House of Representatives and the Committee 
on Finance of the Senate a report on the study con-
ducted under paragraph (1). 
‘‘(4) FUNDING.—In addition to amounts other-
wise available, there is appropriated to the Centers 
for Medicare & Medicaid Services Program Manage-
ment Account for fiscal year 2026, out of any
amounts in the Treasury not otherwise appropriated, 
$2,500,000, to remain available until expended, for 
purposes of carrying out this subsection.’’. 
SEC. 4. MEDICARE IMPROVEMENT FUND. 
Section 1898(b)(1) of the Social Security Act (42 
U.S.C. 
1395iii(b)(1)) 
is 
amended 
by 
striking 
‘‘$1,403,000,000’’ and inserting ‘‘$1,400,500,000’’. 
Passed the House of Representatives December 1, 
2025. 
Attest: 
Clerk.
119TH CONGRESS 
1ST SESSION 
H. R. 4313 
AN ACT 
To amend title XVIII of the Social Security Act to 
extend acute hospital care at home waiver flexi-
bilities, and to require an additional study and 
report on such flexibilities.