Securing Access to Care for Seniors in Critical Condition Act of 2025

This bill changes how Medicare pays long-term care hospitals for very sick patients. It adds a new “high acuity” test so some hospital stays won’t get the lower, “site‑neutral” payment. If a patient’s case is rated highly complex under Medicare’s long‑term care grouping system (a relative weight of at least 0.8), the hospital can be paid at the higher long‑term care rate. This applies to discharges on or after October 1, 2026.

Key points

• Who is affected: Medicare patients in long‑term care hospitals and the hospitals that treat them.
• What changes: Adds a “high acuity” path to avoid lower site‑neutral payments when a case meets a complexity score of 0.8 or higher in the MS‑LTC‑DRG system.
• When: For hospital discharges on or after October 1, 2026.

In short, more very sick patients treated in long‑term care hospitals could count for higher Medicare payments, which may help protect access to specialized care for those patients.