In this letter to HHS, the U.S. Health Care Climate Council expresses its enthusiasm for the incentives in the Inflation Reduction Act (IRA) and their potential to advance climate-smart health care, but outlines the group's concern that under the Centers for Medicaid and Medicare Services (CMS) current Conditions of Participation, some of the IRA opportunities will be inaccessible to hospitals and health systems seeking to embed decarbonization and resilience at their facilities. The council requests that CMS issue a waiver without delay, recognizing Article 517 of the 2023 NEC as an acceptable alternative to Article 517 of the currently required edition.