Medically Tailored Home-Delivered Meals Program Pilot Act
The Medically Tailored Home-Delivered Meals Program Pilot Act would create a six-year demonstration under Medicare (Part A) to test a model in which selected hospitals provide medically tailored home-delivered meals and medical nutrition therapy to certain high-risk patients after discharge. The program aims to improve clinical health outcomes and reduce hospital readmissions by furnishing meals designed to meet two-thirds of a patient’s daily nutritional needs and tailored to their medical and cultural needs, along with ongoing medical nutrition therapy. Hospitals would be paid (with no patient cost-sharing) and would be required to screen discharged patients for eligibility, provide meals for periods starting at 12 weeks and continuing in 12-week cycles up to a year, and report data to the federal government for evaluation. The Secretary would select at least 40 eligible hospitals to participate, beginning within 6 years of enactment, and funding would come from the Hospital Insurance Trust Fund with budget-neutral reductions to hospital payments to offset program costs.
Key Points
- 1Establishes a six-year Medically Tailored Home-Delivered Meals Program (Sec. 1866H) under Part E of the Social Security Act, beginning no later than 30 months after enactment.
- 2Requires the Secretary to select at least 40 eligible hospitals (discharge-capable inpatient facilities) to participate by June 30, 2027, if they meet staffing, quality, and integrity criteria.
- 3Minimum program requirements for participating hospitals:
- 4- Staffing: access to physician, registered dietitian or nutrition professional, Advanced Practice Nurse, or clinical social worker for screening and medical nutrition therapy.
- 5- Screening and re-screening: discharge screening to identify qualified individuals; re-screen every 12 weeks during participation.
- 6- Medically tailored meals and therapy: provide meals designed by a dietitian to meet two-thirds of the patient’s daily needs for at least 12 weeks (initial period) and through subsequent 12-week cycles for up to one year; include medical nutrition therapy for eligible individuals.
- 7- Data submission: hospitals must provide data to the Secretary to assess program impact.
- 8Payment and cost-sharing: Secretary determines payment amounts; meals and services are paid for without patient cost-sharing (no deductibles/copays/coinsurance under this program).
- 9Monitoring and evaluations: ongoing monitoring of health outcomes, inpatient admissions, post-acute care, and total Part A costs; comparisons with similar beneficiaries not in the program; evaluation of patient and caregiver experiences; quarterly and aggregate reporting to federal committees.
- 10Funding and budget neutrality: program funds come from the Hospital Insurance Trust Fund; reductions in existing 1886(d) payments to participating hospitals are used to keep total program spending in line with hospital payment reductions (budget neutrality).
- 11Definitions: clarifies terms for medical nutrition therapy, medically tailored meals, qualified individuals (including criteria such as Part A eligibility, diet-impacted disease, home residence, functional limitations, absence of hospice, and high risk of readmission), and registered dietitian or nutrition professional.