# 119-hr-3222: SMART Health Care Act

119-hr-3222, SMART Health Care Act, is a 119th Congress bill sponsored by Rep. Spartz, Victoria [R-IN-5] (R-IN); status introduced; PRIA reads it as touching household money (as of 2025-12-21).

- Canonical: https://policyrisk.com/legislation/119-hr-3222
- As of: 2025-12-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-3222
- Congress: 119
- Title: SMART Health Care Act
- Status: introduced
- Introduced: 2025-05-06
- Sponsor: Rep. Spartz, Victoria [R-IN-5] (R-IN)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2025-12-21

## Summary

**Reshapes how Medicare pays for care and drugs.** The SMART Health Care Act changes payment rules across Medicare Advantage, hospital outpatient care, the 340B drug program, and skilled nursing quality adjustments to alter who gets paid and how much.

## Provisions PRIA read

- Bigger quality bonus for nursing homes: benefit, medium. For fiscal year 2025 and later, Medicare would add 2 to 5 points to the SNF quality bonus. The Secretary would set the exact extra amount each year. This is on top of the current 2‑point bonus.
- Lower 340B drug prices for patients: benefit, medium. 340B hospitals and clinics would have to charge no more than what they paid for outpatient drugs. They must pass along any extra discounts or rebates. The Secretary would enforce this, adjust some Medicare drug payments, and post totals paid and received. This could cut out‑of‑pocket costs at 340B…
- Medicare pays office rates at hospital clinics: benefit, medium. Starting January 1, 2026, Medicare would pay physician‑office rates for many services done in on‑campus hospital clinics. Emergency department care would not change. Some rural and safety‑net hospitals would be excluded from these rules. Two current exceptions would stop applying for care on or aft…
- Easier rural status for local hospitals: benefit, medium. Providers that serve mostly local rural residents would count as rural providers for certain services. This could help physician‑owned hospitals in rural areas. It may keep more care close to home and affect Medicare payments.
- Two years of data for Medicare Advantage payments: mixed, medium. Beginning in 2026, Medicare Advantage payments would use two years of diagnoses when available. Plan payments could rise or fall. That may affect premiums, extra benefits, or plan choices.

## Related bills

- 119-hr-5582: Patients Deserve Price Tags Act
- 119-hr-2548: Sanctioning Russia Act of 2025
- 119-hr-1357: Susan Muffley Act of 2025
- 119-hr-3184: PFAS Alternatives Act
- 119-hr-10463: Combat Veterans Retirement Restoration Act
- 119-hr-9228: Health DATA Act of 2026

## Sources
- [119-hr-3222 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/3222)

## Related
- [119-hr-5582: Patients Deserve Price Tags Act](https://policyrisk.com/legislation/119-hr-5582)
- [119-hr-2548: Sanctioning Russia Act of 2025](https://policyrisk.com/legislation/119-hr-2548)
- [119-hr-1357: Susan Muffley Act of 2025](https://policyrisk.com/legislation/119-hr-1357)
- [119-hr-3184: PFAS Alternatives Act](https://policyrisk.com/legislation/119-hr-3184)
- [119-hr-10463: Combat Veterans Retirement Restoration Act](https://policyrisk.com/legislation/119-hr-10463)
- [119-hr-9228: Health DATA Act of 2026](https://policyrisk.com/legislation/119-hr-9228)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-3222 (as of 2025-12-21).