I 
119TH CONGRESS 
1ST SESSION H. R. 5347 
To amend title XVIII of the Social Security Act to ensure the availability 
of appropriate collection types for quality reporting under the Medicare 
Shared Savings Program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 15, 2025 
Mr. BUCHANAN (for himself, Mr. PANETTA, Mr. CRENSHAW, and Mr. 
LAHOOD) introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to ensure 
the availability of appropriate collection types for quality 
reporting under the Medicare Shared Savings Program, 
and for other purposes. 
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 ‘‘Health Care Efficiency 
Through Flexibility Act’’. 
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SEC. 2. ENSURING AVAILABILITY OF APPROPRIATE COL-
LECTION TYPES FOR QUALITY REPORTING 
UNDER THE MEDICARE SHARED SAVINGS 
PROGRAM. 
Section 1899(b)(3)(B) of the Social Security Act (42 
U.S.C. 1395jjj(b)(3)(B)) is amended— 
(1) by striking ‘‘An ACO shall submit’’ and in-
serting the following: 
‘‘(i) IN
GENERAL.—An ACO shall 
submit’’; and 
(2) by adding at the end the following new 
clauses: 
‘‘(ii) REQUIRED
AVAILABILITY
OF 
COLLECTION
TYPES
FOR
CERTAIN 
YEARS.—For 
performance 
years 
2025 
through 2029, the Secretary shall ensure 
that the following collection types (as de-
scribed in section 414.1305 of title 42, 
Code of Federal Regulations (or a suc-
cessor regulation)) are available with re-
spect to each measure described in sub-
paragraph (A)(i) required to be reported 
by an ACO under this paragraph: 
‘‘(I) Electronic clinical quality 
measures. 
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‘‘(II) MIPS clinical quality meas-
ures. 
‘‘(III) Medicare Clinical Quality 
Measures for Accountable Care Orga-
nizations Participating in the Medi-
care Shared Savings Program. 
‘‘(iii) CLARIFICATION
ON
APPLICA-
TION OF DATA COMPLETENESS REQUIRE-
MENTS IN CERTAIN CASES.— 
‘‘(I) IN
GENERAL.—In deter-
mining whether data submitted by an 
ACO with respect to a measure de-
scribed in subparagraph (A)(i) for a 
performance year beginning on or 
after January 1, 2025, satisfies the 
data completeness requirements appli-
cable to such measure under section 
414.1340 of title 42, Code of Federal 
Regulations (or a successor regula-
tion) (as applied pursuant to section 
425.512 of title 42, Code of Federal 
Regulations (or a successor regula-
tion)), the Secretary may not find 
such data to be unrepresentative of 
such ACO’s performance for such 
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year (as described in paragraph (e) of 
such section 414.1340) based solely 
on the fact that such data excludes 
applicable data from 1 or more ACO 
participants in such ACO if— 
‘‘(aa) such data submitted 
by the ACO otherwise complies 
with the data completeness re-
quirements 
of 
such 
section 
414.1340; and 
‘‘(bb) 
such 
ACO 
dem-
onstrates to the satisfaction of 
the Secretary that such ACO 
participant was unable to collect 
such data through the collection 
type (as described in clause (ii)) 
selected by the ACO for the sub-
mission of such data. 
‘‘(II) 
DEFINITION.—In 
this 
clause, the term ‘ACO participant’ 
has the meaning given such term in 
section 425.20 of title 42, Code of 
Federal Regulations (or a successor 
regulation). 
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‘‘(III) 
IMPLEMENTATION.—The 
Secretary may implement this clause 
by program instruction or otherwise.’’. 
SEC. 3. PILOT PROGRAM FOR DIGITAL QUALITY MEASURE 
REPORTING. 
Section 1899(b)(3)(B) of the Social Security Act (42 
U.S.C. 1395jjj(b)(3)(B)), as amended by section 2, is fur-
ther amended by adding at the end the following new 
clause: 
‘‘(iv) PILOT
PROGRAM
FOR
DIGITAL 
QUALITY MEASURE REPORTING.— 
‘‘(I) IN GENERAL.—For each of 
performance 
years 
2028 
through 
2032, the Secretary shall establish a 
digital quality measure reporting pilot 
program (in this clause referred to as 
the ‘program’) under which ACOs se-
lected under subclause (II) for such 
performance year report quality meas-
ures specified by the Secretary under 
subclause (III) for such performance 
year through a digital quality measure 
collection type specified by the Sec-
retary. 
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‘‘(II) 
SELECTION.—The 
Sec-
retary shall select ACOs to participate 
in the program for a performance 
year from among ACOs that submit 
an application at such time and in 
such form and manner as specified by 
the Secretary. 
‘‘(III) SPECIFICATION OF QUAL-
ITY
MEASURES.—For each perform-
ance year of the program, the Sec-
retary shall specify 2 measures de-
scribed in subparagraph (A)(i) other-
wise required to be reported by ACOs 
for such performance year for which 
an ACO selected under subclause (II) 
shall submit data through the collec-
tion type specified in subclause (I). 
‘‘(IV) WAIVER OF REQUIREMENT 
TO REPORT OTHER MEASURES.—The 
Secretary may not require an ACO se-
lected under subclause (II) for a per-
formance year to report data on any 
measure described in subparagraph 
(A) otherwise required to be reported 
by an ACO under this paragraph for 
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such performance year, other than 
such a measure specified under sub-
clause (III) for such performance 
year. 
‘‘(V) DISREGARD OF DATA FOR 
CERTAIN
MEASURES.—The Secretary 
may not take into account any data 
for a measure specified under sub-
clause (III) for a performance year 
submitted by an ACO selected under 
subclause (II) for such performance 
year, or any data for a measure with 
respect to which such ACO is not re-
quired to report data for such per-
formance year under subclause (IV), 
in determining— 
‘‘(aa) whether such ACO has 
met quality performance stand-
ards established by the Secretary 
under subparagraph (C) for such 
performance year; or 
‘‘(bb) any score for the qual-
ity performance category (as de-
scribed 
in 
section 
1848(q)(2)(A)(i)) for an ACO 
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participant (as defined in clause 
(iii)(II)) in such ACO for such 
performance year. 
‘‘(VI) TECHNICAL ASSISTANCE.— 
The Secretary shall provide such tech-
nical assistance to ACOs selected to 
participate in the program as is prac-
ticable. 
‘‘(VII) PROVISION OF INFORMA-
TION.—Not later than December 31, 
2032, the Secretary shall publicly post 
(or include as part of annual rule-
making for this section) the following: 
‘‘(aa) An analysis of the pro-
gram. 
‘‘(bb) Any recommendations 
for increasing submissions of 
data for measures described in 
subparagraph (A)(i) through the 
collection type specified in sub-
clause (I). 
‘‘(cc) A proposed timeline 
for requiring such measures to be 
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submitted through such collection 
type.’’. 
Æ 
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