,,ii  #aai? ,,congress  #a/ ,session    
,s4 #bhcd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #ag          
7legislative day1 ,septemb] #af71       
#bjbe,mr4 ,book] 7= himself1 ,mr4       
,m>%all1 ,mr4 ,cassidy1 & ,ms4 ,smi?7   
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 ,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 ,program 
,pilot ,act4  #b4 ,m$ically tailor$     
home-deliv]$ meals 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 program  7a7

 ,e/abli%m5t ,= ! #f-ye> p]iod beg9n+ n 
lat] ?an #cj mon?s aft] ! date ( !      
enactm5t ( ?is section1 subject to      
subsection 7f71 ! ,secret>y %all        
conduct1 9 accordance ) ! provisions (  
?is section1 a ,m$ically ,tailor$       
,home-,deliv]$ ,meals ,program 79 ?is   
section ref]r$ to z ! ,program7 "u :i*  
select$ hospitals provide m$ically      
tailor$ home-deliv]$ meals "u "p ,a (   
?is title to qualifi$ individuals 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 ,june #cj1 #bjbg1      
select to p>ticipate 9 ! ,program at    
lea/1 subject to subsection 7f71 #dj    
eligible hospitals t atte/ to !         
,secret>y t !y 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 or a critical access
 hospital 7z describ$ 9 section         
#ahbj7;c77#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 has an arrangem5t ) provid]s (      
s]vices or suppli]s or o!r entities t h 
! ability1 to furni% ! s]vices describ$ 
9 subsection 7c72 &  7ii7 su* o!r       
in=mation z ! ,secret>y may require2    
7,b7 9 ! case ( a subsection 7d7        
hospital1 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+ po/$ on ! int]net website ( !  
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices     
7includ+ ,c>e ,comp>e or a successor    
website72 &  7,c7 meets1 z ( ! date (   

selection by ! ,secret>y "u p>agraph    
7#a71 program integrity requirem5ts1 z  
det]m9$ by ! ,secret>y4  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  
,advanc$ ,practice ,nurs+ ,pr(essional  
cl9ical social work] to c>ry out !      
scre5+ & re-scre5+ pursuant to p>agraph 
7#b7 & m$ical nutrition !rapy pursuant  
to p>agraph 7#c77;,b74  7#b7 ,scre5+ &  
re-scre5+ ,! select$ hospital 7includ+  
?r\gh arrangem5ts 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 approv$ or deem$  
to be approv$ by ! ,secret>y to det]m9e 

:e!r su* individuals are qualifi$       
individuals pursuant to subsection      
7g77#c72 &  7,b7 9 ! case ( an          
individual t 0 an inpati5t ( su* select$
 hospital & 0 scre5$ pursuant to        
subp>agraph 7,a7 & det]m9$ 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 subsection 
7g77#c7 to be a qualifi$ individual1 !  
select$ hospital 7includ+ ?r\gh         
arrangem5ts describ$ 9 subsection       
7b77#b77;,a77i77 %all1 ) 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    
weeks foll[+ ! scre5 pursuant to        

p>agraph 7#b77;,a7 & = ea* subsequ5t    
#ab-week p]iod aft] ! rescre5 pursuant  
to p>agraph 7#b77;,b71 = ! duration ( ! 
,program1 = ! 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$s ( !
 qualifi$ individual & are responsive to
 ! individual's m$ical & cultural ne$s  
7su* z an all]gy or diet>y re/rictions  
or o!r religi\s or cultural diet>y      
ne$s72 &  7,b7 provide to su* qualifi$  
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 ! effect ( !      
,program ) respect to ! factors describ$
 9 subsection 7e77#b77;,b74  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 ! ,program1 tak+    
into consid]ation paym5t am\nts f o!r   
pay]s = simil> food-relat$ s]vices4     
7#b7 ,co/-%>+ ,items & s]vices = :i*    
paym5t may be made "u ! ,program %all be
 provid$ )\t application ( d$uctibles1  
copaym5ts1 co9surance1 or o!r co/-%>+ "u
 ?is title4  7e7 ,monitor+ & evaluations
  7#a7 ,program monitor+ ,! ,secret>y   
%all monitor claims & o!r data submitt$ 
to ! ,secret>y ( ea* qualifi$ individual
 receiv+ food "u ! ,program = ! purpose 
( det]m9+ :e!r ! ,program improves heal?
 outcomes = qualifi$ individuals4  7#b7 
,int]m$iate & f9al evaluations & reports
 ,! ,secret>y %all conduct an int]m$iate
 & f9al evaluation ( ! ,program4 ,ea*   
su* evaluation %all-- 7,a7 ) respect to 
individuals det]m9$ to be qualifi$      
individuals & receiv+ food & = !        
relevant p]iods1 det]m9e-- 7i7 an       
analysis ( inpati5t admissions ( su*    
individuals aft] ! initial inpati5t     
admission1 & ! diagnosis-relat$ gr\ps = 

su* admissions2  7ii7 ! numb] (         
admissions to o!r po/-acute c>e s]vices 
( su* individuals1 & ! reasons = su*    
admissions2 &  7iii7 ! total exp5ditures
 "u "p ,a ) respect to su* individuals2 
7,b7 report ! foll[+1 ) a comp>ison to  
comp>able b5efici>ies n p>ticipat+ 9 !  
,program-- 7i7 an assessm5t ( cl9ical   
heal? outcomes1 z def9$ by ! ,secret>y2 
7ii7 *anges 9 ! total co/ ( c>e "u "p ,a
 7includ+ co/s associat$ ) readmission z
 def9$ 9 section #ahhf7q77#e77;,e772 &  
7iii7 pati5t & c>egiv+ exp]i5ce1 includ+
 :e!r su* individuals w\ld h cont9u$ to 
receive ! food if !y 7 requir$ to pay = 
x2  7,c7 obta9 in=mation f hospitals    
ab\t paym5ts made "u ! ,program1 includ+
 :e!r su* paym5ts met or exce$$ su*     
hospitals' co/ incurr$ 9 provid+ s]vices
 "u ! ,program2 &  7,d7 include an      
analysis ( heal? outcomes ( individuals 
receiv+ items & s]vices "u ! ,program   
comp>$ to heal? outcomes ( individuals n
 receiv+ items & s]vices "u ! ,program4 
7#c7 ,reports ,! ,secret>y %all submit  

to ! ,committee on ,ways & ,means ( !   
,h\se ( ,repres5tatives & ! ,committee  
on ,f9ance ( ! ,s5ate-- 7,a7 n lat] ?an 
#c ye>s aft] ! date ( implem5tation ( ! 
,program1 a report ) respect to !       
int]m$iate evaluation "u p>agraph 7#b72 
&  7,b7 n lat] ?an #h ye>s aft] su* date
 ( implem5tation1 a report ) respect to 
! f9al evaluation "u su* p>agraph4  7f7 
,fund+  7#a7 ,9 g5]al ,paym5ts = items &
 s]vices furni%$ "u ! ,program & funds  
necess>y = ! co/s ( c>ry+ out ! ,program
 %all be made f ! ,f$]al ,hospital      
,insurance ,tru/ ,fund "u section #ahag4
  7#b7 ,budget neutrality ,! ,secret>y  
%all r$uce paym5ts made to subsection   
7d7 hospitals "u section #ahhf7;d7 9 a  
mann] su* t ! total am\nt ( su*         
r$uctions = a ye> are e/imat$ to be     
equal to ! total am\nt ( paym5ts made "u
 ! ,program dur+ su* ye>4  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 :o-- 7,a7 is       
entitl$ to b5efits "u "p ,a & is n      
receiv+ simil> b5efits f o!r ,/ate or   
,f$]al programs1 z report$ by !         
individual2  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 
a select$ hospital or rescre5+-- 7i7    
lives at home2  7ii7 is n eligible = or 
admitt$ to ext5d$ c>e s]vices 7z def9$ 9
 section #ahfa7;h772  7iii7 has n made  
an election "u section #ahab7;d77#a7 to 
receive hospice c>e2  7iv7 is 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