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

This bill proposes an amendment to Title XVIII of the Social Security Act, aiming to establish a new criterion that would prevent the application of site-neutral payments to certain discharges from long-term care hospitals (LTCHs) under the Medicare program. The legislation introduces a "high acuity criterion" to address concerns about reimbursement for complex patient care. Under this new criterion, a discharge from an LTCH would qualify for exemption if it is assigned to a Medicare-Severity-Long-Term-Care-Diagnosis-Related-Group (MS-LTC-DRG) with a relative weight of 0.8 or greater. This change is intended to ensure that LTCHs receive appropriate reimbursement for treating medically complex patients. If enacted, these provisions would apply to discharges occurring on or after October 1, 2026 , allowing these specific high-acuity cases to be paid at higher, facility-specific rates rather than the lower site-neutral rates.