Health Care Efficiency Through Flexibility Act

The data completeness clarification provision (Section 2(iii)(I)) now applies to performance years beginning on or after January 1, 2026 instead of January 1, 2025, delaying its effect by one year.

In the digital quality measure reporting pilot (Section 3(iv)(I)), the phrase 'digital quality measure' is now followed by '(as defined by the Secretary),' giving CMS discretion to define the term rather than leaving it open-ended.

The waiver provision in the pilot program (Section 3(iv)(IV)) was narrowed from referencing all measures described in 'subparagraph (A)' to only those in 'subparagraph (A)(i),' limiting which measures are exempted from reporting requirements for pilot participants.

A new Section 4 appropriates $8,000,000 for fiscal year 2026 to the CMS Program Management Account to implement the bill's amendments, and reduces the Medicare Improvement Fund cap from $2,062,000,000 to $2,054,000,000 (a matching $8 million reduction).