Bill · H.R. 3222· House(119-HR-3222)
SMART Health Care Act
- Introduced
- 5/6/2025
- Last activity
- 5/6/2025 — 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.
- Sponsored by
- Victoria Spartz
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
This bill, known as the "SMART Health Care Act," proposes several changes to the Social Security Act. It aims to improve risk adjustment under Medicare Advantage by requiring the use of two years of diagnostic data starting in 2026. The legislation also promotes Medicare site-neutral payments for on-campus outpatient departments. Additionally, it seeks to increase Medicare access for rural communities through physician-owned hospitals. Finally, the bill includes provisions to make drugs more affordable for Medicare patients and improves quality of care at skilled nursing facilities.
Yes· 3 of 8
Does this lower the price of prescription medicines?+8
The bill mandates that outpatient drugs be provided at a price not exceeding the purchase price minus discounts or rebates.
Would people over 65 be better off under this?+7
The bill reduces drug costs and improves Medicare access for seniors.
Would people in rural areas be better off under this?+6
The bill expands Medicare access for rural communities via physician-owned hospitals.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Improved Medicare Advantage Risk Adjustment: Starting in 2026, the Secretary will use two years of diagnostic data under the risk adjustment methodology, which is intended to improve risk adjustment under Medicare Advantage (Section 2).
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Increased Rural Medicare Access: The bill changes requirements for designated health services in rural areas to increase Medicare access for rural communities via physician-owned hospitals (Section 4).
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Drug Affordability for Medicare Patients: Covered entities must ensure patients receive covered outpatient drugs at a price not exceeding the purchase price minus any additional discounts or rebates (Section 5).
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Increased Oversight of Drug Pricing: The Secretary is tasked with establishing a mechanism to ensure compliance, adjust reimbursement rates, and publicly report total amounts paid and received for covered outpatient drugs (Section 5).
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Quality of Care Improvements: The bill adjusts the mechanism for quality of care at skilled nursing facilities by allowing for a range of 2 to 5 percentage points as determined by the Secretary (Section 6).
Potential Negative Impacts for People
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Changes to Site-Neutral Payments: The bill implements a sunset of certain exceptions for applicable items and services on or after January 1, 2026 (Section 3(a)).
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Impact on On-Campus Outpatient Departments: The bill modifies how payments are handled for services furnished by on-campus outpatient departments of a provider, directing that payment be the amount determined under the fee schedule for a physician office setting (Section 3(b)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Seniors+7Good For Rural Residents+6Good For Low Income Households+4
- Healthcare
- Reduces Prescription Drug Costs+8Improves Healthcare Access+5Increases Medicare Funding+3
- Economy And Finance
- Improves Consumer Protection+6
- Social Issues And Justice
- Improves Poverty Reduction+2
- 5/6/2025
- 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.
- Introduced in House