I 
119TH CONGRESS 
1ST SESSION 
H. R. 483 
To direct the Secretary of Health and Human Services to delay the implemen-
tation of electronic clinical quality metrics for accountable care organiza-
tions, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 16, 2025 
Mr. BUCHANAN (for himself, Mr. PANETTA, and Mr. CRENSHAW) introduced 
the following bill; which was referred to the Committee on Energy and 
Commerce, and in addition to the Committee on Ways and Means, 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 com-
mittee concerned 
A BILL 
To direct the Secretary of Health and Human Services to 
delay the implementation of electronic clinical quality 
metrics for accountable care organizations, 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. DELAY IN IMPLEMENTATION OF ECQMS FOR ACOS. 
(a) DELAY OF ECQM IMPLEMENTATION.—The Sec-
retary of Health and Human Services (in this section re-
ferred to as the ‘‘Secretary’’) shall delay the implementa-
tion of the requirement for ACOs to transition from re-
porting quality measures via the Centers for Medicare & 
Medicare Services Web Interface portal to electronic Clin-
ical Quality Metrics (eCQMs), as described in the rule ti-
tled ‘‘Medicare and Medicaid Programs; CY 2025 Pay-
ment Policies under the Physician Fee Schedule and Other 
Changes to Part B Payment and Coverage Policies; Medi-
care Shared Savings Program Requirements; Medicare 
Prescription Drug Inflation Rebate Program; and Medi-
care Overpayments’’ (89 Fed. Reg. 97710 (December 9, 
2024)), until January 1, 2030. 
(b) PILOT
PROGRAM
FOR
DIGITAL
REPORTING 
METHODS.— 
(1) IN GENERAL.—Not later than January 1, 
2026, the Secretary shall establish and commence a 
pilot program to test digital reporting methods for 
quality measures on a subset of ACOs and ACO par-
ticipants that submit an application to participate in 
such pilot program at such time and in such form 
as the Secretary determines appropriate. 
(2) TEMPORARY EXEMPTION FROM ECQM RE-
QUIREMENTS.—An ACO or an ACO participant par-
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ticipating in the pilot program shall be exempt from 
mandatory eCQM reporting requirements during the 
duration of the pilot program. 
(3) NO EFFECT ON PAYMENT INCENTIVES.— 
Participation in the pilot program shall have no ef-
fect on the eligibility of an ACO or an ACO partici-
pant to qualify for or earn an incentive payment 
under section 1833(z) of the Social Security Act (42 
U.S.C. 1395l(z)) or a payment adjustment under 
section 1848(q) of such Act (42 U.S.C. 1395w– 
4(q)). 
(4) TECHNICAL
ASSISTANCE.—The Secretary 
shall provide technical assistance, including waivers 
from any applicable quality reporting requirements, 
to ACOs and providers participating in the pilot pro-
gram to incentivize their participation and to evalu-
ate the efficacy of digital reporting methods. 
(5) REPORT.—Not later than January 1, 2028, 
the Secretary shall submit to Congress a report that 
includes— 
(A) the findings and results of the pilot 
program carried out under paragraph (1); and 
(B) any recommendations for increasing 
the adoption by additional ACOs of the digital 
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reporting methods tested under such pilot pro-
gram. 
(c) DEVELOPMENT OF LONG-TERM DIGITAL QUAL-
ITY REPORTING STANDARDS.— 
(1) IN GENERAL.—Not later than January 1, 
2030, the Secretary shall implement standards for 
digital quality reporting metrics and formats. Such 
standards shall ensure that all EHR systems used 
by an ACO are capable of supporting digital report-
ing methods across a diverse range of practice sizes, 
specialties, and geographic locations. 
(2) CONSULTATION.—In developing the stand-
ards described in paragraph (1), the Secretary shall 
collaborate with relevant stakeholders, including rep-
resentatives of the National Committee for Quality 
Assurance, EHR vendors, ACOs, payers, and na-
tional medical and specialty physician groups. 
(d) CONTINUED
USE
OF
EXISTING
REPORTING 
METHODS.— 
(1) IN GENERAL.—An ACO or ACO participant 
may use the CMS Web Interface portal, MIPS 
CQMs, Medicare CQMs, eCQMs, or any other pre-
viously established quality reporting methods, for the 
purpose of meeting such requirements until the date 
on which the Secretary promulgates the standard-
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