HR5439-119

What This Bill Does

The Medically Tailored Home-Delivered Meals Program Pilot Act creates a Medicare Part A pilot for hospital-linked food and nutrition support. For six years, beginning within 30 months after enactment, CMS must run a program where selected hospitals provide medically tailored home-delivered meals to qualified individuals to improve clinical outcomes and reduce readmissions. By June 30, 2027, CMS must select at least 40 eligible subsection (d) or critical access hospitals that apply, attest that they can furnish required services or have arrangements with providers or suppliers, meet program integrity requirements, and, for subsection (d) hospitals, averaged at least three CMS star-rating stars for the prior two fiscal years. Selected hospitals must screen inpatients during discharge planning, rescreen qualified individuals every 12 weeks, provide medically tailored meals each day for at least 12 weeks and up to one year, and provide medical nutrition therapy. Qualified individuals must be Part A beneficiaries not receiving similar state or federal benefits, have diet-impacted diseases such as kidney disease, congestive heart failure, diabetes, or COPD, live at home at discharge or rescreening, not be in extended care or hospice, be limited in at least two activities of daily living, and meet readmission-risk criteria. CMS must pay hospitals without deductibles, copayments, coinsurance, or other cost-sharing, monitor claims and data, perform intermediate and final evaluations on admissions, post-acute care, Part A expenditures, clinical outcomes, total cost of care, patient and caregiver experience, hospital payment adequacy, and health outcomes, report to Ways and Means and Finance at three and eight years, fund payments from the Hospital Insurance Trust Fund, and reduce subsection (d) hospital payments by an estimated equal amount.

Who Benefits and How

Medicare beneficiaries with diet-impacted diseases benefit from home-delivered medically tailored meals and medical nutrition therapy after hospital discharge. Selected hospitals benefit from Medicare payment for food-related services and a chance to reduce readmissions for high-risk patients. Registered dietitians benefit because meals must be designed for the individual's treatment plan and medical nutrition therapy is required. Medically tailored meal providers benefit from hospital arrangements to furnish meals under the pilot.

Who Bears the Burden and How

CMS program staff must select hospitals, set payment methods, monitor claims, evaluate outcomes, and report to Congress. Selected hospitals must screen, rescreen, deliver or arrange meals, provide medical nutrition therapy, submit data, and meet quality and integrity criteria. Subsection (d) hospitals bear offsetting payment reductions equal to estimated program payments. Hospital Insurance Trust Fund finances program payments and administrative costs.

Key Provisions

• Creates a six-year Medicare Part A medically tailored home-delivered meals pilot.
• Requires CMS to select at least 40 eligible hospitals by June 30, 2027.
• Provides meals and medical nutrition therapy without beneficiary cost-sharing for qualified high-risk Part A beneficiaries.
• Requires intermediate and final evaluations and reports at three and eight years after implementation.
• Funds the pilot through the Hospital Insurance Trust Fund with offsetting subsection (d) hospital payment reductions.