I 
116TH CONGRESS 
1ST SESSION H. R. 4063 
To amend title XVIII of the Social Security Act to provide for coverage 
of certified adult day services under the Medicare program, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 25, 2019 
Ms. SA´NCHEZ (for herself, Mr. COHEN, Ms. MENG, and Ms. ROYBAL-ALLARD) 
introduced the following bill; which was referred to the Committee on 
Ways and Means, and in addition to the Committee on Energy and Com-
merce, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for coverage of certified adult day services under the 
Medicare program, and for other purposes. 
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 ‘‘Medicare Adult Day 
Services Act of 2019’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
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(1) Adult day care can offer services, including 
medical care, rehabilitation therapies, dignified as-
sistance with activities of daily living, nutrition ther-
apy, health monitoring, social interaction, stimu-
lating activities, and transportation, to seniors and 
people with disabilities at no extra cost to the Medi-
care program. 
(2) The care given at adult day services centers 
under an interdisciplinary team provides seniors, 
people with disabilities, and their familial caregivers 
with more care hours and additional services that 
are critical to keeping patients healthier and in the 
homes of the patients instead of in a nursing home, 
and reduces the risk of hospital admission or read-
mission. 
SEC. 3. MEDICARE COVERAGE OF CERTIFIED ADULT DAY 
SERVICES. 
(a) MEDICARE CERTIFIED ADULT DAY SERVICES 
BENEFIT.— 
(1) DEFINITION.—Section 1861 of the Social 
Security Act (42 U.S.C. 1395x) is amended by add-
ing at the end the following new subsection: 
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‘‘Certified Adult Day Services; Adult Day Services Pro-
vider; Certified Adult Day Services Center; Post-In-
stitutional Certified Adult Day Services; Certified 
Adult Day Services Spell of Illness 
‘‘(kkk)(1)(A) The term ‘certified adult day services’ 
means, subject to paragraph (4), the items and services 
described in subparagraph (B) that are furnished to an 
individual who is under the care of a physician— 
‘‘(i) by an adult day services provider (as de-
fined in paragraph (2)) or by another entity under 
an arrangement with such an adult day services pro-
vider to provide such services; 
‘‘(ii) in accordance with a plan (for furnishing 
such items and services to such individual) approved 
and periodically reviewed by such physician; and 
‘‘(iii) in a certified adult day services center (as 
defined in paragraph (3)). 
‘‘(B) For purposes of subparagraph (A), the items 
and services described in this subparagraph are the fol-
lowing: 
‘‘(i) Part-time or intermittent services (as de-
fined in subparagraph (C)(i)) provided by or under 
the supervision of a registered professional nurse. 
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‘‘(ii) Physical or occupational therapy or 
speech-language pathology services, or any combina-
tion of such services. 
‘‘(iii) Medical social services under the direction 
of a physician. 
‘‘(iv) Nutritional meals, including special diets, 
as ordered by a physician. 
‘‘(v) A program of supervised activities (that 
meets such criteria as the Secretary determines ap-
propriate) designed to promote physical and mental 
health that are furnished in a group setting for a pe-
riod of not fewer than 4 and not greater than 8 
hours per day. 
‘‘(vi) A medication management program (as 
defined in subparagraph (C)(ii)). 
‘‘(vii) Medical supplies (including catheters, 
catheter supplies, ostomy bags, and supplies related 
to ostomy care, and a covered osteoporosis drug (as 
defined in subsection (kk)), but excluding other 
drugs and biologicals) and durable medical equip-
ment. 
‘‘(viii) Transportation of the individual de-
scribed in subparagraph (A) to and from a certified 
adult day services center in connection with the pro-
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