,,ii  #aah? ,,congress  #a/ ,session    
,s4 #bacc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #bb1 #bjbc ,ms4  
,/ab5[ 7= h]self1 ,mr4 ,m>%all1 ,mr4    
,book]1 & ,mr4 ,cassidy7 introduc$ !    
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xviii ( ! ,social      
,security ,act to e/abli% a ,m$ically   
,tailor$ ,home-,deliv]$ ,meals          
,demon/ration ,program to te/ a paym5t &
 s]vice deliv]y model "u "p ,a ( ,m$ic>e
 to improve cl9ical heal? outcomes &    
r$uce ! rate ( readmissions ( c]ta9     
individuals4  #a4 ,%ort title ,?is ,act 
may be cit$ z ! ,m$ically ,tailor$      
,home-,deliv]$ ,meals ,demon/ration     
,act4  #b4 ,m$ically ,tailor$           
,home-,deliv]$ ,meals ,demon/ration     
,program ,"p ,e ( title ,,xviii ( !     
,social ,security ,act is am5d$ by      
ins]t+ aft] section #ahff;,g 7#db       
,u4,s4,c4 #acie;cc-#g7 ! foll[+ new     
section3  #ahff;,h4 ,m$ically ,tailor$  
,home-,deliv]$ ,meals ,demon/ration     

,program  7a7 ,e/abli%m5t ,= ! #d-ye>   
p]iod beg9n+ n lat] ?an #cj mon?s aft] !
 date ( ! enactm5t ( ?is section1 !     
,secret>y %all conduct1 9 accordance ) !
 provisions ( ?is section1 a ,m$ically  
,tailor$ ,home-,deliv]$ ,meals          
,demon/ration ,program 79 ?is section   
ref]r$ to z ! ,program7 to te/ a paym5t 
& s]vice deliv]y model "u :i* select$   
hospitals provide m$ically tailor$      
home-deliv]$ meals "u "p ,a ( ?is title 
to qualifi$ individuals1 ) respect to   
su* hospitals1 to improve cl9ical heal? 
outcomes & r$uce ! rate ( readmissions (
 su* individuals4  7b7 ,selection (     
hospitals ,to p>ticipate 9 ,program     
7#a7 ,select$ hospitals ,"u ! ,program1 
! ,secret>y %all1 n lat] ?an ,janu>y #a1
 #bjbd1 select to p>ticipate 9 !        
,program at lea/ #bj eligible hospitals 
across all geographic regions1 )        
consid]ation giv5 to eligible hospitals 
locat$ 9 rural areas & o!r und]s]v$     
communities1 t ! ,secret>y det]m9es h ! 
capacity to satisfy ! requirem5ts       

describ$ 9 subsection 7c74 ,9 ?is       
section1 ea* su* eligible hospital s    
select$ %all be ref]r$ to z a select$   
hospital4  7#b7 ,eligible hospitals ,=  
purposes ( ?is section1 ! t]m eligible  
hospital means a subsection 7d7 hospital
 7z def9$ 9 section #ahhf7;d77#a77;,b77 
t-- 7,a7 submits to ! ,secret>y an      
application1 at su* "t & 9 su* =m &     
mann] z specifi$ by ! ,secret>y1 t      
conta9s--  7i7 an atte/ation 79 su* =m &
 mann] z specifi$ by ! ,secret>y7 t su* 
hospital has ! ability1 or is "u an     
arrangem5t ) a provid] ( s]vices1       
suppli]1 or o!r entity t has ! ability1 
to comply ) ! requirem5ts describ$ 9    
subsection 7c72 &  7ii7 su* o!r         
in=mation z ! ,secret>y may require2    
7,b7 has1 = ! #b mo/ rec5t fiscal ye>s  
end+ prior to ! date ( selection by !   
,secret>y "u p>agraph 7#a71 av]ag$ at   
lea/ #c />s = ! ov]all hospital quality 
/> rat+ on ! int]net website ( ! ,c5t]s 
= ,m$ic>e  ,m$icaid ,s]vices 7includ+   
,c>e ,comp>e or a successor website72 & 

7,c7 is n1 z ( ! date ( selection by !  
,secret>y "u p>agraph 7#a71 subject to--
  7i7 ! requirem5t to return any        
ov]paym5t pursuant to section           
#aabh;,j7d72 or  7ii7 any activity      
describ$ 9 section #ahic7;b7 7relat+ to 
,m$ic>e integrity program actions74  7c7
 ,m9imum ,program requirem5ts ,"u !     
,program1 a select$ hospital %all comply
 ) ea* ( ! foll[+ requirem5ts3 7#a7     
,/aff+ ,! select$ hospital %all provide 
7includ+ ?r\gh an arrangem5t describ$ 9 
subsection 7b77#b77;,a77i771 = !        
duration ( ! p>ticipation ( ! hospital  
"u ! ,program1 a physician1 regi/]$     
dietitian or nutrition pr(essional1 or  
cl9ical social work] to c>ry out !      
scre5+ & re-scre5+ pursuant to p>agraph 
7#b71 & m$ical nutrition !rapy pursuant 
to p>agraph 7#c77;,b74  7#b7 ,scre5+ &  
re-scre5+ ,! select$ hospital 7includ+  
?r\gh an arrangem5t describ$ 9          
subsection 7b77#b77;,a77i77 %all-- 7,a7 
z "p ( ! dis*>ge plann+ process describ$
 9 section #ahfa7;ee71 scre5 individuals

 t are inpati5ts ( su* select$ hospital 
) validat$ scre5+ tools 7z develop$ by !
 ,secret>y7 to det]m9e :e!r su*         
individuals are qualifi$ individuals2 & 
7,b7 9 ! case ( an individual det]m9$   
pursuant to subp>agraph 7,a7 or ?is     
subp>agraph to be a qualifi$ individual1
 re-scre5 su* individual ) validat$     
scre5+ tools 7z det]m9$ by ! ,secret>y7 
e #ab weeks aft] su* det]m9ation occurr+
 dur+ ! p>ticipation ( ! hospital "u !  
,program to det]m9e :e!r su* individual 
cont9ues to be a qualifi$ individual4   
7#c7 ,provid+ m$ically tailor$          
home-deliv]$ meals & m$ical nutrition   
!rapy ,9 ! case ( an individual t is    
det]m9$ by ! select$ hospital pursuant  
to p>agraph 7#b7 to be a qualifi$       
individual1 ! select$ hospital 7includ+ 
?r\gh an arrangem5t describ$ 9          
subsection 7b77#b77;,a77i77 %all )      
respect to ! p]iod dur+ :i* su* hospital
 is p>ticipat+ 9 ! ,program--  7,a7     
provide1 = ea* day dur+ a p]iod ( at    
lea/ #ab weeks1 = ! prep>ation & deliv]y

 to su* individual ( at lea/ #b m$ically
 tailor$ home-deliv]$ meals 7or a       
portion$ equival5t7 t meet at lea/      
two-?irds ( ! daily nutritional ne$s ( !
 qualifi$ individual2 &  7,b7 provide to
 su* qualifi$ individual1 9 connection )
 deliv]+ su* meals & = a p]iod ( at lea/
 #ab weeks & n m ?an #a ye>1 m$ical     
nutrition !rapy4  7#d7 ,data submission 
,! select$ hospital %all submit to !    
,secret>y data1 9 su* =m1 mann]1 &      
frequ5cy z designat$ by ! ,secret>y1 s t
 ! ,secret>y may det]m9e ! affect ( !   
,program ) respect to ! factors describ$
 9 subsection 7e77#b77;,b74  7#e7       
,additional requirem5ts ,! select$      
hospital %all satisfy su* additional    
requirem5ts z may be specifi$ by !      
,secret>y4  7d7 ,paym5t2 co/-,%>+  7#a7 
,paym5t ,! ,secret>y %all det]m9e ! =m1 
mann]1 & am\nt ( paym5t to be provid$ to
 a select$ hospital "u ! ,program4  7#b7
 ,co/-%>+ ,items & s]vices = :i* paym5t 
may be made "u ! ,program %all be       
provid$ )\t application ( any d$uctible1

 copaym5t1 co9surance1 or o!r co/-%>+ "u
 ?is title4  7e7 ,evaluations  7#a7     
,assess+ cl9ical heal? outcomes ,!      
,secret>y %all assess ! cl9ical heal?   
outcomes ( ea* individual :o is det]m9$ 
by a select$ hospital pursuant to       
subsection 7c77#b7 to be a qualifi$     
individual = a p]iod ( at lea/ #ab weeks
 & n m ?an #a ye> aft] ! date on :i* su*
 individual is s det]m9$ "u subp>agraph 
7,a7 ( su* subsection4  7#b7 ,int]m$iate
 & f9al evaluations ,! ,secret>y %all   
conduct an int]m$iate & f9al evaluation 
( ! ,program4 ,ea* su* evaluation %all--
  7,a7 bas$ on ! assessm5ts conduct$ "u 
p>agraph 7#a71 ) respect to individuals 
det]m9$ to be qualifi$ individuals & !  
p]iods = :i* su* assessm5ts are s       
conduct$1 det]m9e-- 7i7 ! numb] (       
inpati5t admissions ( su* individuals2  
7ii7 ! numb] ( admissions to skill$     
nurs+ facilities ( su* individuals2 &   
7iii7 ! total exp5ditures "u "p ,a )    
respect to su* individuals2  7,b7       
det]m9e ! ext5t to :i* ! ,program has-- 

7i7 improv$ cl9ical heal? outcomes1 z   
def9$ by ! ,secret>y2  7ii7 r$uc$ ! co/ 
( c>e "u "p ,a 7includ+ co/s associat$ )
 readmission z def9$ 9 section          
#ahhf7q77#e77;,e772 &  7iii7 increas$   
pati5t satisfaction1 z def9$ by !       
,secret>y2 &  7,c7 specify ! =m1 mann]1 
& am\nts ( paym5ts made "u ! ,program   
pursuant to subsection 7d77#a7 & !      
effectiv5ess ( su* paym5t =m1 mann]1 &  
am\nts4  7#c7 ,reports ,! ,secret>y %all
 submit to ,congress--  7,a7 n lat] ?an 
#c ye>s aft] ! date ( implem5tation ( ! 
,program1 a report ) respect to !       
int]m$iate evaluation "u p>agraph 7#b72 
&  7,b7 n lat] ?an #f ye>s aft] su* date
 ( implem5tation1 a report ) respect to 
! f9al evaluation "u su* p>agraph4  7f7 
,au?orization ( appropriations ,!re are 
au?oriz$ to be appropriat$ su* sums z   
are necess>y to c>ry out ?is section4   
7g7 ,def9itions ,9 ?is section3  7#a7   
,m$ical nutrition !rapy ,! t]m m$ical   
nutrition !rapy has ! mean+ giv5 su* t]m
 9 section #ahfa7vv77#a74  7#b7         

,m$ically tailor$ home-deliv]$ meal ,!  
t]m m$ically tailor$ home-deliv]$ meal  
means1 ) respect to a qualifi$          
individual1 a meal t is design$ by a    
regi/]$ dietitian or nutrition          
pr(essional = ! treatm5t plan ( !       
qualifi$ individual4  7#c7 ,qualifi$    
individual ,! t]m qualifi$ individual   
means an individual1 ) respect to a     
select$ hospital1 :o-- 7,a7 is entitl$  
to b5efits "u "p ,a2  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 appropriate72 &  7,c7 at ! "t (
 dis*>ge f su* hospital--  7i7 lives at 
home2  7ii7 is n eligible =--  7,i7     
ext5d$ c>e s]vices 7z def9$ 9 section   
#ahfa7;h772  7,,ii7 po/-hospital ext5d$ 
c>e s]vices 7z def9$ 9 section          
#ahfa7;i772  7,,iii7 home heal? s]vices 
7z def9$ 9 section #ahfa7m772 or  7,,iv7
 po/-in/itutional home heal? s]vices 7z 
def9$ 9 section #ahfa7tt772  7iii7 has n

 made an election "u section            
#ahab7;d77#a7 to receive hospice c>e2   
7iv7 is c]tifi$ by a physician at ! "t (
 dis*>ge to be limit$ ) respect to at   
lea/ #b ( ! activities ( daily liv+ 7z  
describ$ 9 section #ggjb;,b7c77#b77;,b7 
( ! ,int]nal ,rev5ue ,code ( #aihf72 &  
7v7 meets any o!r crit]ia = high-risk ( 
readmission 7z det]m9$ by ! ,secret>y74 
7#d7 ,regi/]$ dietitian or nutrition    
pr(essional ,! t]m regi/]$ dietitian or 
nutrition pr(essional has ! mean+ giv5  
su* t]m 9 section #ahfa7vv77#b74  4