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 committee concerned.
The SMART Health Care Act makes several changes to Medicare to address what supporters view as payment system abuses and improve affordability. The bill modifies how Medicare Advantage plans are paid by requiring the use of two years of diagnostic data (starting in 2026) to better reflect patient health status. It also promotes "site-neutral payments" by eliminating certain payment exceptions for hospital outpatient departments effective January 1, 2026, meaning these facilities would receive the same payment rates as independent physician offices for identical services—though rural and critical access hospitals are exempted from this requirement. Additionally, the legislation allows physician-owned hospitals to operate in rural areas under certain conditions and requires covered entities receiving federal drug discounts to pass those savings directly to Medicare patients, with the Secretary establishing enforcement mechanisms and public reporting of drug pricing data. The bill also gives the Secretary discretion to adjust skilled nursing facility payment rates by 2 to 5 percentage points in fiscal year 2025 and beyond.
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