STAR Act
- Bill Number
- H.R. 9468
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-06-25: Referred to the House Committee on Ways and Means.
- Last Updated
- 2026-07-09T21:20:14Z
AI-Generated Summary
Purpose of the Legislation This bill amends title XVIII of the Social Security Act to adjust Medicare payment rates for long-term care hospitals (LTCHs). It extends existing site-neutral payment reductions while introducing new criteria that allow certain high-acuity discharges to receive full LTCH rates instead.
Key Provisions
- Short Title: The legislation is named the "Saving Today's Acute-Care Resources Act" or "STAR Act."
- Extension of Site-Neutral Reductions: Amends section 1886(m)(6)(B)(iv) to extend site-neutral payment reductions through fiscal year 2032 (previously scheduled to end in 2026).
- New High Acuity Criterion: Adds a new clause (v) to section 1886(m)(6)(A) that exempts qualifying discharges from site-neutral rates if:
- The LTCH stay follows a discharge from a subsection (d) hospital or critical access hospital.
- The patient is assigned to a specified MS-LTC-DRG (relative weight of 0.8 or greater, not based on 96+ hours of ventilator services).
- The LTCH meets specific eligibility conditions (enrolled before enactment, mid-build requirements, or state certificate of need).
- The discharge occurs on or after October 1, 2026.
- Modifications to Existing Criteria: Updates the ICU and ventilator criteria to include prior stays in an LTCH or critical access hospital for discharges on or after October 1, 2026.
Significant Changes to Existing Law
- Extends the duration of site-neutral payments by six years.
- Creates a new pathway for LTCHs to avoid reduced payments for high-acuity cases that previously would have triggered site-neutral rates.
- Broadens the qualifying prior-stay requirements for ICU and ventilator exemptions starting in fiscal year 2027.
Potential Impacts
- Government Agencies: Increases Medicare program spending on LTCH services by allowing more cases to receive higher LTCH rates instead of acute-care rates.
- Citizens: May affect access to LTCH care for certain Medicare beneficiaries by influencing which facilities qualify for full payments.
- International Relations: No direct effects identified.
Main Stakeholders Affected
- Long-term care hospitals (particularly those meeting the new high-acuity or mid-build criteria).
- The Centers for Medicare & Medicaid Services (CMS), which administers the payment system.
- Medicare beneficiaries receiving LTCH care.
- Acute-care hospitals and critical access hospitals that discharge patients to LTCHs.
Notable Legal, Constitutional, or Political Implications The bill modifies Medicare reimbursement rules under the Social Security Act, potentially affecting the balance between cost containment and provider viability. It introduces detailed eligibility conditions tied to enrollment dates and construction agreements, which may require regulatory clarification by CMS. No constitutional issues are raised in the text.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (2)
Rep. Miller, Carol D. [R-WV-1], Rep. Smucker, Lloyd [R-PA-11]
Recent Actions
- 2026-06-25: Referred to the House Committee on Ways and Means.
- 2026-06-25: Introduced in House
- 2026-06-25: Introduced in House
Bill Versions
- Saving Today’s Acute-Care Resources Act — issued 2026-06-25 — PDF (6 pages)