Medically Tailored Home-Delivered Meals Program Pilot Act
This bill, the Medically Tailored Home-Delivered Meals Program Pilot Act, would amend Medicare to create a six-year pilot program (within Part A, the Hospital Insurance program) called the Medically Tailored Home-Delivered Meals Program. Beginning no later than 30 months after enactment, the Secretary of Health and Human Services would run the program through selected hospitals that deliver medically tailored meals to qualified individuals who have diet-related diseases and are at high risk of readmission. The program would provide at-home meals (at least two per day) and medical nutrition therapy for a defined period after hospital discharge or screening, with the goal of improving health outcomes and reducing hospital readmissions. Hospitals would be paid for these services without cost-sharing by patients, and payments would be budget-neutral by reducing other Medicare payments to participating hospitals. The bill also requires ongoing data collection and formal evaluations to assess impacts on health outcomes, readmissions, post-acute care use, and overall Part A costs, with published reports to Congress. Key features include selecting at least 40 eligible hospitals, strict eligibility and program integrity criteria, mandated staffing (including physicians or equivalent nutrition professionals and social workers), a defined cycle of screening and re-screening to identify qualified individuals, and a defined benefit package of at least 12 weeks of at-home meals (two meals per day) plus medical nutrition therapy, extended for subsequent 12-week periods as long as the program runs. The pilot would be evaluated at multiple time points, and findings would inform future policy.
Key Points
- 1Establishment and duration: Creates a six-year Medically Tailored Home-Delivered Meals Program under Part A, starting within 30 months after enactment, with ongoing participation as defined by the statute.
- 2Hospital participation and eligibility: Requires the Secretary to select at least 40 eligible hospitals by June 30, 2027, based on capacity to meet program requirements and quality standards; eligible hospitals include certain types of acute-care and critical access hospitals meeting attestation, star-rating, and integrity criteria.
- 3Qualified individuals and services: Defines a qualified individual as a Part A beneficiary with a diet-related disease, living at home at discharge or after screening, not eligible for extended care or hospice, limited in at least two activities of daily living, and at high risk for readmission; participating hospitals must screen and re-screen patients and provide medically tailored home-delivered meals (two meals per day) for at least 12 weeks following the initial screen, plus medical nutrition therapy for a period of at least 12 weeks and up to 1 year.
- 4Payment and cost-sharing: The Secretary determines how payments are made and the amount, with no patient cost-sharing (no deductibles, copays, or coinsurance) for Program items/services; payments are funded from the Federal Hospital Insurance Trust Fund and are made in a budget-neutral manner by reducing other Medicare payments to participating hospitals.
- 5Data, monitoring, and evaluations: The Secretary must monitor claims and data, conduct intermediate and final evaluations comparing participants to similar non-participants, assess clinical outcomes, readmissions, and total Part A costs, and report findings to Congress (3-year interim and 8-year final evaluations).
- 6Definitions and scope: Provides definitions for medical nutrition therapy, medically tailored home-delivered meals, qualified individuals, and the role of registered dietitians or nutrition professionals; relies on existing Medicare terms and provisions (e.g., hospital discharge planning, Part A definitions).