I 
118TH CONGRESS 
1ST SESSION H. R. 6780 
To amend title XVIII of the Social Security Act to establish a Medically 
Tailored Home-Delivered Meals Demonstration Program to test a pay-
ment and service delivery model under part A of Medicare to improve 
clinical health outcomes and reduce the rate of readmissions of certain 
individuals. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 14, 2023 
Mr. MCGOVERN (for himself, Ms. MALLIOTAKIS, Ms. PINGREE, Mr. EVANS, 
and Mr. FITZPATRICK) introduced the following bill; which was referred 
to the Committee on Ways and Means 
A BILL 
To amend title XVIII of the Social Security Act to establish 
a Medically Tailored Home-Delivered Meals Demonstra-
tion Program to test a payment and service delivery 
model under part A of Medicare to improve clinical 
health outcomes and reduce the rate of readmissions 
of certain individuals. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medically Tailored 
Home-Delivered Meals Demonstration Pilot Act’’. 
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SEC. 2. MEDICALLY TAILORED HOME-DELIVERED MEALS 
DEMONSTRATION PROGRAM. 
Part E of title XVIII of the Social Security Act is 
amended by inserting after section 1866G (42 U.S.C. 
1395cc–7) the following new section: 
‘‘SEC. 1866H. MEDICALLY TAILORED HOME-DELIVERED 
MEALS DEMONSTRATION PROGRAM. 
‘‘(a) ESTABLISHMENT.—For the 4-year period begin-
ning not later than 30 months after the date of the enact-
ment of this section, the Secretary shall conduct, in ac-
cordance with the provisions of this section, a Medically 
Tailored Home-Delivered Meals Demonstration Program 
(in this section referred to as the ‘Program’) to test a pay-
ment and service delivery model under which selected hos-
pitals provide medically tailored home-delivered meals 
under part A of this title to qualified individuals, with re-
spect to such hospitals, to improve clinical health outcomes 
and reduce the rate of readmissions of such individuals. 
‘‘(b) SELECTION OF HOSPITALS TO PARTICIPATE IN 
PROGRAM.— 
‘‘(1) SELECTED HOSPITALS.—Under the Pro-
gram, the Secretary shall, not later than January 1, 
2024, select to participate in the Program at least 
20 eligible hospitals across all geographic regions, 
with consideration given to eligible hospitals located 
in rural areas and other underserved communities, 
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that the Secretary determines have the capacity to 
satisfy the requirements described in subsection (c). 
In this section, each such eligible hospital so selected 
shall be referred to as a ‘selected hospital’. 
‘‘(2) ELIGIBLE
HOSPITALS.—For purposes of 
this section, the term ‘eligible hospital’ means a sub-
section 
(d) 
hospital 
(as 
defined 
in 
section 
1886(d)(1)(B)) that— 
‘‘(A) submits to the Secretary an applica-
tion, at such time and in such form and manner 
as specified by the Secretary, that contains— 
‘‘(i) an attestation (in such form and 
manner as specified by the Secretary) that 
such hospital has the ability, or has in ef-
fect an arrangement with a provider of 
services, supplier, or other entity with at 
least 1 year of experience in furnishing 
medically tailored home-delivered meals 
that has the ability, to comply with the re-
quirements described in subsection (c); and 
‘‘(ii) such other information as the 
Secretary may require; 
‘‘(B) has, for the 2 most recent fiscal years 
ending prior to the date of selection by the Sec-
retary under paragraph (1), averaged at least 3 
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stars for the overall hospital quality star rating 
on the Internet website of the Centers for Medi-
care & Medicaid Services (including Care Com-
pare or a successor website); and 
‘‘(C) is not, as of the date of selection by 
the Secretary under paragraph (1), subject to— 
‘‘(i) the requirement to return any 
overpayment pursuant to section 1128J(d); 
or 
‘‘(ii) any activity described in section 
1893(b) (relating to Medicare integrity 
program actions). 
‘‘(c) MINIMUM PROGRAM REQUIREMENTS.—Under 
the Program, a selected hospital shall comply with each 
of the following requirements: 
‘‘(1) STAFFING.—The selected hospital shall 
provide (including through an arrangement de-
scribed in subsection (b)(2)(A)(i)), for the duration 
of the participation of the hospital under the Pro-
gram, a physician, registered dietitian or nutrition 
professional, or clinical social worker to carry out 
the screening and re-screening pursuant to para-
graph (2), and medical nutrition therapy pursuant 
to paragraph (3)(B). 
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‘‘(2) SCREENING AND RE-SCREENING.—The se-
lected hospital (including through an arrangement 
described in subsection (b)(2)(A)(i)) shall— 
‘‘(A) as part of the discharge planning 
process described in section 1861(ee), screen in-
dividuals that are inpatients of such selected 
hospital with validated screening tools (as devel-
oped by the Secretary) to determine whether 
such individuals are qualified individuals; and 
‘‘(B) in the case of an individual deter-
mined pursuant to subparagraph (A) or this 
subparagraph to be a qualified individual, re- 
screen such individual with validated screening 
tools (as determined by the Secretary) every 12 
weeks after such determination occurring dur-
ing the participation of the hospital under the 
Program to determine whether such individual 
continues to be a qualified individual. 
‘‘(3) PROVIDING MEDICALLY TAILORED HOME- 
DELIVERED MEALS AND MEDICAL NUTRITION THER-
APY.—In the case of an individual that is deter-
mined by the selected hospital pursuant to para-
graph (2) to be a qualified individual, the selected 
hospital (including through an arrangement de-
scribed in subsection (b)(2)(A)(i)) shall with respect 
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to the period during which such hospital is partici-
pating in the Program— 
‘‘(A) provide, for each day during a period 
of at least 12 weeks, for the preparation and 
delivery to such individual of at least 2 medi-
cally tailored home-delivered meals (or a 
portioned equivalent) that meet at least two- 
thirds of the daily nutritional needs of the 
qualified individual; and 
‘‘(B) provide to such qualified individual, 
in connection with delivering such meals and 
for a period of at least 12 weeks and not more 
than 1 year, medical nutrition therapy. 
‘‘(4) DATA SUBMISSION.—The selected hospital 
shall submit to the Secretary data, in such form, 
manner, and frequency as designated by the Sec-
retary, so that the Secretary may determine the af-
fect of the Program with respect to the factors de-
scribed in subsection (e)(2)(B). 
‘‘(5) ADDITIONAL
REQUIREMENTS.—The se-
lected hospital shall satisfy such additional require-
ments as may be specified by the Secretary. 
‘‘(d) PAYMENT; COST-SHARING.— 
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‘‘(1) PAYMENT.—The Secretary shall determine 
the form, manner, and amount of payment to be 
provided to a selected hospital under the Program. 
‘‘(2) COST-SHARING.—Items and services for 
which payment may be made under the Program 
shall be provided without application of any deduct-
ible, copayment, coinsurance, or other cost-sharing 
under this title. 
‘‘(e) EVALUATIONS.— 
‘‘(1) 
ASSESSING
CLINICAL
HEALTH
OUT-
COMES.—The Secretary shall assess the clinical 
health outcomes of each individual who is deter-
mined by a selected hospital pursuant to subsection 
(c)(2) to be a qualified individual for a period of at 
least 12 weeks and not more than 1 year after the 
date on which such individual is so determined 
under subparagraph (A) of such subsection. 
‘‘(2) INTERMEDIATE
AND
FINAL
EVALUA-
TIONS.—The Secretary shall conduct an inter-
mediate and final evaluation of the Program. Each 
such evaluation shall— 
‘‘(A) based on the assessments conducted 
under paragraph (1), with respect to individuals 
determined to be qualified individuals and the 
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periods for which such assessments are so con-
ducted, determine— 
‘‘(i) the number of inpatient admis-
sions of such individuals; 
‘‘(ii) the number of admissions to 
skilled nursing facilities of such individ-
uals; and 
‘‘(iii) the total expenditures under 
part A with respect to such individuals; 
‘‘(B) determine the extent to which the 
Program has— 
‘‘(i) improved clinical health outcomes, 
as defined by the Secretary; 
‘‘(ii) reduced the cost of care under 
part A (including costs associated with re-
admission 
as 
defined 
in 
section 
1886(q)(5)(E)); and 
‘‘(iii) increased patient satisfaction, as 
defined by the Secretary; and 
‘‘(C) specify the form, manner, and 
amounts of payments made under the Program 
pursuant to subsection (d)(1) and the effective-
ness of such payment form, manner, and 
amounts. 
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‘‘(3) REPORTS.—The Secretary shall submit to 
Congress— 
‘‘(A) not later than 3 years after the date 
of implementation of the Program, a report 
with respect to the intermediate evaluation 
under paragraph (2); and 
‘‘(B) not later than 6 years after such date 
of implementation, a report with respect to the 
final evaluation under such paragraph. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to carry out this section. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) MEDICAL
NUTRITION
THERAPY.—The 
term ‘medical nutrition therapy’ has the meaning 
given such term in section 1861(vv)(1). 
‘‘(2) MEDICALLY TAILORED HOME-DELIVERED 
MEAL.—The term ‘medically tailored home-delivered 
meal’ means, with respect to a qualified individual, 
a meal that is designed by a registered dietitian or 
nutritional professional for the treatment plan of the 
qualified individual. 
‘‘(3) QUALIFIED INDIVIDUAL.—The term ‘quali-
fied individual’ means an individual, with respect to 
a selected hospital, who— 
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‘‘(A) is entitled to benefits under part A; 
‘‘(B) has a diet-impacted disease (such as 
kidney disease, congestive heart failure, diabe-
tes, chronic obstructive pulmonary disease, or 
any other disease the Secretary determines ap-
propriate); and 
‘‘(C) at the time of discharge from such 
hospital— 
‘‘(i) lives at home; 
‘‘(ii) is not eligible for— 
‘‘(I) extended care services (as 
defined in section 1861(h)); 
‘‘(II) post-hospital extended care 
services 
(as 
defined 
in 
section 
1861(i)); or 
‘‘(III) 
post-institutional 
home 
health services (as defined in section 
1861(tt)); 
‘‘(iii) has not made an election under 
section 1812(d)(1) to receive hospice care; 
‘‘(iv) is certified by a physician at the 
time of discharge to be limited with respect 
to at least 2 of the activities of daily living 
(as described in section 7702B(c)(2)(B) of 
the Internal Revenue Code of 1986); and 
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‘‘(v) meets any other criteria for high- 
risk of readmission (as determined by the 
Secretary). 
‘‘(4) REGISTERED
DIETITIAN
OR
NUTRITION 
PROFESSIONAL.—The term ‘registered dietitian or 
nutrition professional’ has the meaning given such 
term in section 1861(vv)(2).’’. 
Æ 
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