H.R. 1924 — Securing Access to Care for Seniors in Critical Condition Act of 2025

This section establishes a high acuity criterion for excluding certain discharges from long-term care hospitals (LTCHs) from Medicare site-neutral payments (i.e., reduced payments equivalent to inpatient prospective payment system rates) and revises the list of such exclusion criteria to include it. (As background, site-neutral payments under the LTCH prospective payment system, enacted in 2018, apply to LTCH cases not meeting specified clinical criteria—such as a prior 3-day acute-care hospitalization or extended ventilator use—allowing full LTCH payments, which are typically higher, for complex cases.) The high acuity criterion applies to discharges assigned to a Medicare Severity Long-Term Care Diagnosis Related Group (MS-LTC-DRG) with a relative weight of 0.8 or greater in the applicable fiscal year and occurring on or after October 1, 2026. (Thus, qualifying discharges receive full LTCH payments.)