I 
119TH CONGRESS 
1ST SESSION H. R. 5439 
To amend title XVIII of the Social Security Act to establish a Medically 
Tailored Home-Delivered Meals 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. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 17, 2025 
Mr. MCGOVERN
(for himself, Ms. MALLIOTAKIS, Ms. PINGREE, Mr. 
FITZPATRICK, and Mr. EVANS of Pennsylvania) 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 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 Program Pilot Act’’. 
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SEC. 2. MEDICALLY TAILORED HOME-DELIVERED MEALS 
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 PROGRAM. 
‘‘(a) ESTABLISHMENT.—For the 6-year period begin-
ning not later than 30 months after the date of the enact-
ment of this section, subject to subsection (f), the Sec-
retary shall conduct, in accordance with the provisions of 
this section, a Medically Tailored Home-Delivered Meals 
Program (in this section referred to as the ‘Program’) 
under which selected hospitals provide medically tailored 
home-delivered meals under part A of this title to qualified 
individuals 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 June 30, 
2027, select to participate in the Program at least, 
subject to subsection (f), 40 eligible hospitals that 
attest to the Secretary that they have the capacity 
to satisfy the requirements described in subsection 
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(c). In this section, each such eligible hospital so se-
lected 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)) or a critical access hospital (as de-
scribed in section 1820(c)(2)) 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 an ar-
rangement with providers of services or 
suppliers or other entities that have the 
ability, to furnish the services described in 
subsection (c); and 
‘‘(ii) such other information as the 
Secretary may require; 
‘‘(B) in the case of a subsection (d) hos-
pital, 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 
stars for the overall hospital quality star rating 
posted on the internet website of the Centers 
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for Medicare & Medicaid Services (including 
Care Compare or a successor website); and 
‘‘(C) meets, as of the date of selection by 
the Secretary under paragraph (1), program in-
tegrity requirements, as determined by the Sec-
retary. 
‘‘(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, Advanced Practice Nursing Profes-
sional, or clinical social worker to carry out the 
screening and re-screening pursuant to paragraph 
(2), medical nutrition therapy pursuant to para-
graph (3)(B). 
‘‘(2) SCREENING AND RE-SCREENING.—The se-
lected hospital (including through arrangements de-
scribed 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 
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hospital with validated screening tools approved 
or deemed to be approved by the Secretary to 
determine whether such individuals are quali-
fied individuals pursuant to subsection (h)(3); 
and 
‘‘(B) in the case of an individual that was 
an inpatient of such selected hospital and was 
screened pursuant to subparagraph (A) and de-
termined 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 sub-
section (h)(3) to be a qualified individual, the se-
lected hospital (including through arrangements de-
scribed in subsection (b)(2)(A)(i)) shall, with respect 
to the period during which such hospital is partici-
pating in the Program— 
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‘‘(A) provide, for each day during a period 
of at least 12 weeks following the screen pursu-
ant to paragraph (2)(A) and for each subse-
quent 12-week period after the rescreen pursu-
ant to paragraph (2)(B), for the duration of the 
Program, for the preparation and delivery to 
such individual of at least 2 medically tailored 
home-delivered meals (or a portioned equiva-
lent) that meet at least two-thirds of the daily 
nutritional needs of the qualified individual and 
are responsive to the individual’s medical and 
cultural needs (such as an allergy or dietary re-
strictions or other religious or cultural dietary 
needs); 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 ef-
fect of the Program with respect to the factors de-
scribed in subsection (e)(2)(B). 
‘‘(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, 
taking into consideration payment amounts from 
other payers for similar food-related services. 
‘‘(2) COST-SHARING.—Items and services for 
which payment may be made under the Program 
shall be provided without application of deductibles, 
copayments, coinsurance, or other cost-sharing 
under this title. 
‘‘(e) MONITORING AND EVALUATIONS.— 
‘‘(1) PROGRAM
MONITORING.—The Secretary 
shall monitor claims and other data submitted to the 
Secretary of each qualified individual receiving food 
under the Program for the purpose of determining 
whether the Program improves health outcomes for 
qualified individuals. 
‘‘(2) INTERMEDIATE AND FINAL EVALUATIONS 
AND REPORTS.—The Secretary shall conduct an in-
termediate and final evaluation of the Program. 
Each such evaluation shall— 
‘‘(A) with respect to individuals determined 
to be qualified individuals and receiving food 
and for the relevant periods, determine— 
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‘‘(i) an analysis of inpatient admis-
sions of such individuals after the initial 
inpatient admission, and the diagnosis-re-
lated groups for such admissions; 
‘‘(ii) the number of admissions to 
other post-acute care services of such indi-
viduals, and the reasons for such admis-
sions; and 
‘‘(iii) the total expenditures under 
part A with respect to such individuals; 
‘‘(B) report the following, with a compari-
son to comparable beneficiaries not partici-
pating in the Program— 
‘‘(i) an assessment of clinical health 
outcomes, as defined by the Secretary; 
‘‘(ii) changes in the total cost of care 
under part A (including costs associated 
with readmission as defined in section 
1866(q)(5)(E)); and 
‘‘(iii) patient and caregiving experi-
ence, including whether such individuals 
would have continued to receive the food if 
they were required to pay for it; 
‘‘(C) obtain information from hospitals 
about payments made under the Program, in-
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cluding whether such payments met or exceeded 
such hospitals’ cost incurred in providing serv-
ices under the Program; and 
‘‘(D) an analysis of health outcomes of in-
dividuals receiving items and services under the 
Program compared to health outcomes of indi-
viduals not receiving items and services in the 
Program. 
‘‘(3) REPORTS.—The Secretary shall submit to 
the Committee on Ways and Means of the House of 
Representatives and the Committee on Finance of 
the Senate— 
‘‘(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 8 years after such date 
of implementation, a report with respect to the 
final evaluation under such paragraph. 
‘‘(f) FUNDING.— 
‘‘(1) IN
GENERAL.—Payments for items and 
services furnished under the Program and funds 
necessary for the costs of carrying out the Program 
shall be made from the Hospital Insurance Trust 
Fund under section 1817. 
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‘‘(2) BUDGET
NEUTRALITY.—The Secretary 
shall reduce payments made to subsection (d) hos-
pitals under section 1886(d) in a manner such that 
the total amount of such reductions for a year are 
estimated to be equal to the total amount of pay-
ments made under the Program during such year. 
‘‘(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 
nutrition professional for the treatment plan of the 
qualified individual. 
‘‘(3) QUALIFIED INDIVIDUAL.—The term ‘quali-
fied individual’ means an individual, who— 
‘‘(A) is entitled to benefits under part A 
and is not receiving similar benefits from other 
state or Federal programs, as reported by the 
individual; 
‘‘(B) has a diet-impacted disease (such as 
kidney disease, congestive heart failure, diabe-
tes, chronic obstructive pulmonary disease, or 
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any other disease the Secretary determines ap-
propriate); 
‘‘(C) at the time of discharge from a se-
lected hospital or rescreening— 
‘‘(i) lives at home; 
‘‘(ii) is not eligible for or admitted to 
extended care services (as defined in sec-
tion 1861(h)); 
‘‘(iii) has not made an election under 
section 1812(d)(1) to receive hospice care; 
‘‘(iv) is limited with respect to at least 
2 of the activities of daily living (as de-
scribed in section 7702B(c)(2)(B) of the 
Internal Revenue Code of 1986); and 
‘‘(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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