H.R. 4773 – ACO Assignment Improvement Act of 2025

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Updated November 23, 2025 at 11:11 PM UTC

The ACO Assignment Improvement Act of 2025 updates the Medicare Shared Savings Program to better assign beneficiaries and expand covered services. It modifies the language of Section 1899(c)(1) and, starting in 2027, includes primary‑care services delivered by ACO professionals as part of the program. The changes affect Medicare beneficiaries, accountable care organizations, and the primary‑care providers that work with them.

Key Provisions

Adds a new sub‑paragraph (C) to Section 1899(c)(1) of the Social Security Act, stating that for performance years beginning on or after Jan. 1, 2027, primary‑care services provided by an ACO professional (as defined in subsection (h)(1)(B)) are covered under the Medicare Shared Savings Program.

Legislative Activity

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HouseIntro Referral Latest Action

Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.

Ways and Means Committee

July 25, 2025

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HouseIntro Referral

Introduced in House

July 25, 2025

HouseIntro Referral

Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.

Ways and Means Committee

July 25, 2025

Bill Text

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Introduced in HouseIssued July 25, 2025

I

119th CONGRESS

1st Session

H. R. 4773

IN THE HOUSE OF REPRESENTATIVES

July 25, 2025

Mr. Smith of Nebraska (for himself and Ms. DelBene) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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

A BILL

To amend title XVIII of the Social Security Act to establish a SNF-at-home program under the Medicare program.

1.

Short title

This Act may be cited as the ACO Assignment Improvement Act of 2025.

2.

Improvements to the assignment of beneficiaries under the medicare shared savings program

Section 1899(c)(1) of the Social Security Act (42 U.S.C. 1395jjj(c)(1)) is amended—

(1)

in subparagraph (A), by striking and at the end;

(2)

in subparagraph (B), by striking the period at the end and inserting ; and; and

(3)

by adding at the end the following new subparagraph:

(C)

in the case of performance years beginning on or after January 1, 2027, primary care services provided under this title by an ACO professional described in subsection (h)(1)(B)

.