,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #fggd  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #h1 #bjbj,mr4    
,mc,govern 7= himself1 ,ms4 ,p+ree1     
,mrs4 ,walorski1 & ,mr4 ,m>%all7        
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means1 & 9    
addition to ! ,committee on ,rules1 = a 
p]iod to be subsequ5tly det]m9$ by !    
,speak]1 9 ea* case = consid]ation ( su*
 provisions z fall )9 ! jurisdiction ( !
 committee conc]n$  ,a ,,bill  ,to am5d 
title ,,xviii ( ! ,social ,security ,act
 to require ! ,secret>y ( ,heal? &      
,human ,s]vices to conduct a            
demon/ration program to assess ! effects
 ( a hospital provid+ to qualifi$       
individuals m$ically tailor$            
home-deliv]$ meals1 & = o!r purposes4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,m$ically ,tailor$ ,home-,deliv]$     
,meals ,demon/ration ,pilot ,act (      
#bjbj4  #b4 ,m$ically ,tailor$          
,home-,deliv]$ ,meals ,demon/ration     
,pilot ,program  7a7 ,9 g5]al ,"p ,a (  

title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq47 is am5d$ 
by add+ at ! end ! foll[+ new section3  
#ahbb4 ,m$ically ,tailor$ ,home-,deliv]$
 ,meals ,demon/ration ,pilot ,program   
7a7 ,e/abli%m5t  7#a7 ,9 g5]al ,n lat]  
?an #a ye> aft] ! date ( ! enactm5t (   
?is ,act1 ! ,secret>y %all conduct "u   
?is section ! ,m$ically ,tailor$        
,home-,deliv]$ ,meals ,demon/ration     
,pilot ,program 79 ?is section ref]r$ to
 z ! ,program7 = a #c-ye> p]iod to      
assess ! effects ( a cov]$ hospital     
provid+ to qualifi$ individuals m$ically
 tailor$ home-deliv]$ meals4 ,"u !      
,program1 ! ,secret>y %all-- 7,a7 select
 eligible hospitals to p>ticipate 9 !   
,program 9 accordance ) p>agraph 7#b72  
7,b7 e/abli% proc$ures = cov]$ hospitals
 to c>ry out ! requirem5ts ( ! ,program 
describ$ "u p>agraph 7#c72  7,c7 make   
paym5ts to cov]$ hospitals = items &    
s]vices provid$ to qualifi$ individuals 
9 accordance ) subsection 7b72 &  7,d7  
submit a report on ! ,program 9         

accordance ) subsection 7c74  7#b7      
,selection  7,a7 ,9 g5]al ,= purposes ( 
?is subsection1 a cov]$ hospital is a   
hospital-- 7i7 t submits to ! ,secret>y 
an application at su* "t1 9 su* mann]1 &
 conta9+ su* in=mation z ! ,secret>y may
 require2  7ii7 is select$ by !         
,secret>y to c>ry out ! ,program = n m  
?an a #c-ye> p]iod2 &  7iii7 is a       
subsection 7d7 hospital "u section      
#ahhf4  7,b7 ,requirem5t ,! ,secret>y   
%all select at lea/ #bj cov]$ hospitals 
locat$ 9 at lea/ #aj diff]5t ,/ates to  
c>ry out ! ,program4  7#c7 ,program     
requirem5ts  7,a7 ,/aff ,a cov]$        
hospital %all ma9ta9 on /aff a          
physician1 regi/]$ dietitian or         
nutrition pr(essional1 or cl9ical social
 work] to-- 7i7 scre5 an individual t is
 an inpati5t ( su* hospital ) validat$  
scre5+ tools to det]m9e :e!r su*        
individual is a qualifi$ individual2    
7ii7 re-scre5 ea* individual receiv+    
m$ically tailor$ home-deliv]$ meals )   
validat$ scre5+ tools e #ab weeks to    

det]m9e :e!r su* individual is qualifi$ 
to cont9ue receiv+ m$ically tailor$     
home-deliv]$ meals2  7iii7 9 ! case su* 
an individual is det]m9$ to be a        
qualifi$ individual "u clause 7i7 or    
7ii71 ensure su* individual receives    
m$ically tailor$ home-deliv]$ meals     
pursuant to a contract describ$ 9       
subp>agraph 7,b72  7iv7 provide to su*  
individual det]m9$ to be a qualifi$     
individual "u clause 7i7 or 7ii7 m$ical 
nutrition !rapy furni%$ by a regi/]$    
dietitian or nutritional pr(essional or 
ensure t ! organization describ$ 9      
subp>agraph 7,b7 t deliv]s meals to su* 
individual provides to su* individual   
su* !rapy 7z appropriate72 &  7v7       
monitor ! cl9ical heal? outcomes 7bas$  
on measures develop$ by ! ,secret>y     
consi/5t ) ,/ate law7 ( ea* individual t
 receive m$ically tailor$ home-deliv]$  
meals4  7,b7 ,contract to deliv] meals  
7i7 ,9 g5]al ,a cov]$ hospital %all ent]
 into a contract 79 accordance ) crit]ia
 e/abli%$ by ! ,secret>y7 ) at lea/ #a  

organization t has at lea/ #a ye> (     
exp]i5ce prep>+ & deliv]+ m$ically      
tailor$ meals simil> to meals describ$ 9
 subsection 7e77#b7 & provid+ individual
 nutritional c\nsel+ or m$ical nutrition
 !rapy 9 connection ) deliv]+ meals4    
7ii7 ,numb] ( meals ,! contract describ$
 9 clause 7i7 %all provide =-- 7,i7 at  
lea/ #b m$ically tailor$ home-deliv]$   
meals 7or a portion$ equival5t7 ea* day 
t meet at lea/ two-?irds ( ! daily      
nutritional ne$s ( ! qualifi$           
individual2 &  7,,ii7 at lea/ #ab weeks 
( m$ically tailor$ home-deliv]$ meals4  
7iii7 ,option to provide meals =        
c>egiv]s or dep5d5ts "u ! age ( #ah ,9 !
 case an individual is det]m9$ to be a  
qualifi$ individual "u clause 7i7 or    
7ii7 ( subp>agraph 7,a71 ! cov]$        
hospital may contract ) ! organization  
describ$ 9 clause 7i7 to provide to !   
prim>y c>egiv] ( ! individual or a      
dep5d5t "u ! age ( #ah t resides 9 !    
h\sehold ( su* individual a meal !      
organization det]m9es appropriate4  7,c7

 ,report by hospital ,n lat] ?an #a ye> 
aft] ! date ! cov]$ hospital beg9s to   
p>ticipate 9 ! ,program1 & annually     
!reaft]1 a hospital select$ "u p>agraph 
7#b7 %all submit to ! ,secret>y a report
 on-- 7i7 ! impact ( m$ically tailor$   
home-deliv]$ meals on cl9ical heal?     
outcomes describ$ 9 subp>agraph 7,a77v72
  7ii7 ! impact ( m$ically tailor$      
home-deliv]$ meals on hospital co/s     
7includ+ ! co/s associat$ ) !           
readmission 7z def9$ 9                  
#ahhf7q77#e77;,e77 ( individuals72 &    
7iii7 any o!r in=mation necess>y to     
evaluate ! ,program4  7b7 ,paym5t ,"u ! 
,program1 paym5t = an item or s]vice    
provid$ "u ?is section %all be made f ! 
,f$]al ,hospital ,insurance ,tru/ ,fund 
= ! type1 am\nt1 frequ5cy1 & duration ( 
su* an item or s]vice z ! ,secret>y     
det]m9es appropriate z if ! item or     
s]vice 0 payable "u section #ahhf4      
,paym5t = a contract describ$ 9         
subsection 7a77#c77;,b7 %all be made f !
 ,f$]al ,hospital ,insurance ,tru/ ,fund

 = ! am\nt ! ,secret>y det]m9es         
appropriate4  7c7 ,report by ,secret>y  
,n lat] ?an #c ye>s aft] ! date ( !     
enactm5t ( ?is ,act1 & #f ye>s aft] su* 
date1 ! ,secret>y %all submit to !      
,committee on ,ways & ,means ( ! ,h\se (
 ,repres5tatives & ! ,committee on      
,f9ance ( ! ,s5ate a report on !        
,program4 ,su* report %all include a    
summ>y (1 evaluation (1 & recomm5dations
 on :e!r to cov] m$ically tailor$       
home-deliv]$ meals z a b5efit "u ?is "p4
  7d7 ,he>+s  7#a7 ,9 g5]al ,!          
,committee on ,ways & ,means ( ! ,h\se (
 ,repres5tatives %all1 n lat] ?an #ij   
days aft] ! date ! ,secret>y submits a  
report "u subsection 7c71 hold a he>+ on
 ! recomm5dations submitt$ by !         
,secret>y "u subsection 7c74  7#b7      
,ex]cise ( rulemak+ au?ority ,p>agraph  
7#a7 is enact$-- 7,a7 z an ex]cise (    
rulemak+ p[] ( ! ,h\se (                
,repres5tatives1 &1 z su*1 %all be      
consid]$ z "p ( ! rules ( ! ,h\se1 & su*
 rules %all sup]s$e any o!r rule ( !    

,h\se only to ! ext5t t rule is         
inconsi/5t !re)2 &  7,b7 ) full         
recognition ( ! con/itutional "r ( ei!r 
,h\se to *ange su* rules 7s f> z relat+ 
to ! proc$ure 9 su* ,h\se7 at any "t1 9 
! same mann]1 & to ! same ext5t z 9 !   
case ( any o!r rule ( ! ,h\se4  7e7     
,def9itions ,9 ?is section3 7#a7 ,m$ical
 nutrition !rapy ,! t]m m$ical nutrition
 !rapy means1 = ! purpose ( disease     
managem5t1 nutritional1 diagno/ics1 &   
c\nsel+1 s]vices t are furni%$ by a     
regi/]$ dietitian or nutrition          
pr(essional4  7#b7 ,m$ically tailor$    
home-deliv]$ meal ,! t]m m$ically       
tailor$ home-deliv]$ meal means a meal t
 is design$ by a regi/]$ dietitian or   
nutritional pr(essional-- 7,a7 = !      
treatm5t plan ( a qualifi$ individual2 &
  7,b7 to improve heal? outcomes1 l[] ! 
co/ ( c>e1 & increase ! pati5t          
satisfaction ( su* qualifi$ individual4 
7#c7 ,qualifi$ individual ,! t]m        
qualifi$ individual means an individual 
:o-- 7,a7 is entitl$ to b5efits "u ?is  

"p2  7,b7 has a diet-impact$ disease    
7su* z kidney disease1 conge/ive he>t   
failure1 diabetes1 *ronic ob/ructive    
pulmon>y disease1 or any o!r disease !  
,secret>y det]m9es appropriate7 t is    
likely to cause ! individual to require 
c>e at a hospital2 &  7,c7 has at lea/  
"o activity ( daily liv+ limitation4    
7#d7 ,regi/]$ dietitian or nutrition    
pr(essional ,! t]m dietitian or         
nutrition pr(essional has ! mean+ giv5  
su* t]m 9 section #ahfa7vv77#b74  7#e7  
,validat$ scre5+ tool ,! t]m validat$   
scre5+ tool means a que/ionnaire t has  
be5 psy*ometrically te/$ = reliability &
 validity 9 assess+ ! pres5ce ( a       
condition 9 ! individual :o is scre5$ by
 su* que/ionnaire4  4