,i #aaith ,,congress #b;d ,session ,h4 ,r4 #hibc ,,in ,,the ,,house ,,of ,,representatives ,may #bj1 #bjbf,ms4 ,castor of ,florida 7for herself and ,mr4 ,buchanan7 introduced the following bill2 which was referred to the ,committee on ,ways and ,means1 and in addition to the ,committee on ,energy and ,commerce1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to establish a #b-year demonstration program for hospitals to provide outpatient observation services to ,medicare beneficiaries at home4 #a4 ,short title ,this ,act may be cited as the ,at ,home ,observation and ,medical ,evaluation ,services ,act of #bjbf or the ,at ,,home ,services ,act 4 #b4 ,demonstration program for hospitals to provide outpatient observation services to ,medicare beneficiaries at home ,title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 is amended by inserting after section #ahff;,g the following new section3 #ahff;,h4 ,demonstration program for hospitals to provide outpatient observation services at home 7a7 ,in general ,not later than #a year after the date of enactment of this section1 the ,secretary shall implement a #b-year demonstration program 7in this section referred to as the ,program7 for hospitals to provide outpatient observation services to eligible beneficiaries in the homes of such beneficiaries4 ,in implementing such ,program1 the ,secretary shall grant waivers and flexibilities 7as described in subsection 7b77 to an individual hospital that submits a request for such waivers and flexibilities and meets specified criteria 7as described in subsection 7c77 in order to participate in the ,program4 7b7 ,waivers and flexibilities ,for the purposes of subsection 7a71 the waivers and flexibilities described in this paragraph are the following waivers and flexibilities that are made available to individual hospitals under the ,acute ,hospital ,care at ,home initiative of the ,secretary during the period described in section #ahff;,g7a77#a73 7#a7 ,subject to subsection 7c77#b71 waiver of the requirements to provide #bd-;hour nursing services on premises and for the immediate availability of a registered nurse under section #dhb4bc7;b7 of title #db1 ,code of ,federal ,regulations 7or any successor regulation71 and the waivers of the physical environment and ,life ,safety ,code requirements under section #dhb4da of title #db1 ,code of ,federal ,regulations 7or any successor regulation74 7#b7 ,waiver of the telehealth requirements under clause 7i7 of section #ahcd7m77#d77;,c71 as amended by section #daac7;a7 of the ,health ,extenders1 ,improving ,access to ,medicare1 ,medicaid1 and ,,chip1 and ,strengthening ,public ,health ,act of #bjbb1 such that the originating sites described in clause 7ii7 of such section shall include the home or temporary residence of the individual4 7#c7 ,other waivers and flexibilities that1 as of the date of enactment of this section1 were in place for such initiative during such emergency period4 7c7 ,specified criteria ,for purposes of subsection 7a71 the specified criteria for granting such waivers and flexibilities to individual hospitals are3 7#a7 ,the hospital and any other entities providing services under arrangements with the hospital shall ensure that the standard of care to treat an eligible beneficiary at home is the same as the standard of care to treat such beneficiary as an inpatient of the hospital4 7#b7 ,the hospital shall meet all patient safety standards determined appropriate by the ,secretary1 in addition to those that otherwise apply to the hospital1 except those for which the waivers and flexibilities under this subsection apply4 7#c7 ,the hospital shall provide to the ,secretary1 at a time1 form and manner determined by the ,secretary1 any data and information the ,secretary determines necessary to do the following3 7,a7 ,monitor the quality of care furnished1 and to the extent practicable ensure the safety of1 eligible beneficiaries and analyze costs of such care4 7,b7 ,undertake the study described in subsection 7e74 7#d7 ,the hospital meets such other requirements and conditions as the ,secretary determines appropriate4 7d7 ,termination ,the ,secretary may terminate a hospital from participation in the ,program 7and the waivers and flexibilities applicable to such hospital7 if the ,secretary determines that the hospital no longer meets the criteria described in subsection 7c74 7e7 ,study and report 7#a7 ,in general ,the ,secretary shall conduct a study to-- 7,a7 analyze1 to the extent practicable1 the criteria established by hospitals to determine which beneficiaries may be furnished services under the ,program2 and 7,b7 analyze and compare1 to the extent practicable-- 7i7 the quality of care furnished to beneficiaries with similar conditions and characteristics in the hospital setting and through the ,program1 including health outcomes1 hospital readmission rates1 hospital mortality rates1 length of stay1 infection rates1 and patient experience of care2 7ii7 clinical conditions treated and diagnosis-related groups of discharges from the hospital setting and under the ,program2 7iii7 costs incurred by furnishing care in the hospital setting and through the ,program2 7iv7 the quantity1 mix and intensity of such services 7such as in-person visits and virtual contacts with patients7 furnished under the ,program and furnished in the hospital setting2 and 7v7 socioeconomic information on beneficiaries treated under the ,program1 including racial and ethnic data1 income1 and whether such beneficiaries are dually eligible for benefits under this title and title ,,xix4 7#b7 ,report ,not later than #a year after the completion of the ,program1 the ,secretary shall post on a website of the ,centers for ,medicare ,medicaid ,services a report on the study conducted under paragraph 7#a74 7f7 ,implementation ,notwithstanding any other provision of law1 the ,secretary may implement this section by program instruction or otherwise4 7g7 ,publicly available information ,the ,secretary shall1 as feasible1 make the information collected under subsections 7c77#c7 and 7e77#a7 available on the ,medicare4gov ,internet website 7or a successor website74 4