HR 4313 United States House · 119th Congress

Hospital Inpatient Services Modernization Act

HR 4313, the Hospital Inpatient Services Modernization Act, extends Medicare's waiver allowing acute hospital care at home until 2030 (previously expiring in 2025). It requires the Secretary of Health and Human Services to conduct a detailed study by September 2028 comparing home-based hospital care to traditional inpatient care. The study must analyze quality metrics (like readmission rates and patient outcomes), costs, staffing patterns, and patient demographics - including racial, ethnic, and socioeconomic data - across participating and non-participating hospitals. This bill directly affects Medicare beneficiaries receiving home-based care and hospitals operating under the waiver program.

Issues: ✓ Healthcare

Bill status passed 3 of 5 stages cleared

Introduction

Jul 2025

Committee Review

Dec 2025

House Passage

Dec 2025

Senate Passage

President

Introduced Jul 10, 2025 Last action Dec 2, 2025

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What changed between versions

Introduced in House → Engrossed in House · 4 edits · Dec 1, 2025

MODERATE

The engrossed version of HR 4313 makes three main changes from the introduced version: it specifies a more precise date range for extending the acute hospital care at home waiver (from January 30, 2026 to September 30, 2030 rather than simply 2025 to 2030), adds a new $2.5 million funding provision for fiscal year 2026 to support the required study on that initiative, and adds an entirely new section reducing the Medicare Improvement Fund by $2.5 million to offset the new spending.

Scope change

The bill's scope expanded slightly with the addition of a new Section 4 affecting the Medicare Improvement Fund, and the waiver extension now has a more precise start date (January 30, 2026) rather than simply '2025.' The overall policy goals remain the same.

TIMELINE

The waiver extension date was changed from a simple '2025 to 2030' to the more specific 'January 30, 2026 to September 30, 2030,' clarifying the exact start and end dates of the extended flexibilities.

FISCAL

A new paragraph (4) under the study section appropriates $2,500,000 for fiscal year 2026 to the CMS Program Management Account, available until expended, specifically to carry out the subsequent study on acute hospital care at home.

A new Section 4 reduces the Medicare Improvement Fund from $1,403,000,000 to $1,400,500,000 (a $2.5 million reduction), which serves as the budgetary offset for the new study funding.

REQUIREMENT

New language gives the Secretary authority to require that data and information be submitted through hospital cost reports, survey instruments, medical record information, or other means the Secretary determines appropriate.

Floor votes

How they voted

This bill passed the House by voice vote (no roll call recorded).

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Dec 2, 2025

Committee

Received in the Senate and Read twice and referred to the Committee on Finance.

upper

Dec 1, 2025

Introduced

On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H4935)

lower

Dec 1, 2025

Lower · Passed

Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H4935)

lower

Dec 1, 2025

Introduced

Mr. Smith (MO) moved to suspend the rules and pass the bill, as amended.

lower

Oct 31, 2025

Lower · Passed

Reported (Amended) by the Committee on Ways and Means. H. Rept. 119-359.

lower

Sep 17, 2025

Introduced

Ordered to be Reported in the Nature of a Substitute (Amended) by the Yeas and Nays: 44 - 0.

lower

Sep 17, 2025

Lower · Passed

Committee Consideration and Mark-up Session Held

lower

Jul 10, 2025

Committee

Referred to the House Committee on Ways and Means.

lower

Jul 10, 2025

Introduced

Introduced in House

lower

1 primary · 8 co-sponsors