Sponsors (5)
The bill standardizes reporting options, protects partial ACO submissions, funds and pilots digital reporting to reduce provider burden and improve measurement, but does so by giving the Secretary more flexible implementation authority, risking reduced transparency and completeness of oversight, imposing modest costs on smaller providers, and shifting $8 million in Medicare Improvement Fund resources without net savings.
Hospitals, health systems, and ACO participants will have standardized reporting options (eCQM, MIPS CQMs, Medicare CQMs) for required measures in 2025–2029, reducing technical variability and reporting burden.
ACOs and their participants are protected from being penalized solely because one or more participants' data are missing beginning in 2026, reducing the risk that partial-but-meaningful submissions are rejected.
Selected ACOs in the pilot will receive technical assistance and temporary reporting waivers, lowering administrative burden while testing new reporting approaches.
Medicare beneficiaries and patients may face less complete quality oversight if ACOs are allowed to submit measures with missing participant data, which could mask gaps in care.
Granting the Secretary authority to implement the data-completeness rule by program instruction (rather than through notice-and-comment rulemaking) reduces transparency and limits formal stakeholder input into implementation changes.
Smaller ACOs and participating providers may incur meaningful implementation and technical costs to adopt or map to Secretary-defined digital/collection formats (applies to both the required collection types and pilot participation).
Based on analysis of 4 sections of legislative text.
Expands ACO quality-measure reporting options, protects certain ACO submissions from being deemed unrepresentative, creates a 2028–2032 digital quality-measure pilot, and funds implementation with $8M in FY2026.
Makes targeted changes to Medicare accountable care organization (ACO) quality reporting rules, requires CMS to offer multiple clinical quality measure collection types for ACO reporting in 2025–2029, and bars CMS from declaring submitted ACO measure data unrepresentative solely because some participant data are excluded starting in 2026. Creates a time-limited pilot (2028–2032) for reporting specified measures via a digital quality measure collection, provides technical assistance and limited waivers for pilot participants, and requires CMS to publicly report pilot information by the end of 2032. Provides $8 million in FY2026 to implement these changes and reduces a related Medicare Improvement Fund statutory amount by $8 million to offset the appropriation.
Official title: Health Care Efficiency Through Flexibility Act
Introduced September 15, 2025 by Vernon G. Buchanan · Last progress July 13, 2026