Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021
Bill: H.R.5370 | Sponsor: Rep. McGovern, James P. (D-MA)
Policy area: Health

Summary:
Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021
This bill requires the Centers for Medicare & Medicaid Services to establish a demonstration program to allow hospitals to provide medically tailored, home-delivered meals to Medicare beneficiaries who have a diet-impacted disease (e.g., kidney disease) and have daily living limitations.
Participating hospitals must (1) retain a physician, registered dietitian or nutrition professional, or clinical social worker to screen, monitor, and coordinate services for individuals who receive meals through the program; and (2) contract with experienced organizations for meal delivery. Hospitals may choose to also provide meals to an individual's primary caregiver or to a dependent under the age of 18 who resides in the same household.

To amend title XVIII of the Social Security Act to require the 
   Secretary of Health and Human Services to conduct a demonstration 
  program to assess the effects of a hospital providing to qualified 
  individuals medically tailored home-delivered meals, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives 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 of 2021''.

SEC. 2. MEDICALLY TAILORED HOME-DELIVERED MEALS DEMONSTRATION PILOT 
              PROGRAM.

    (a) In General.--Part A of title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.) is amended by adding at the end the following 
new section:

``SEC. 1823. MEDICALLY TAILORED HOME-DELIVERED MEALS DEMONSTRATION 
              PILOT PROGRAM.

    ``(a) Establishment.--
            ``(1) In general.--Not later than 1 year after the date of 
        the enactment of this section, the Secretary shall conduct 
        under this section the Medically Tailored Home-Delivered Meals 
        Demonstration Pilot Program (in this section referred to as the 
        `Program') for a 3-year period to assess the effects of a 
        covered hospital providing to qualified individuals medically 
        tailored home-delivered meals. Under the Program, the Secretary 
        shall--
                    ``(A) select eligible hospitals to participate in 
                the Program in accordance with paragraph (2);
                    ``(B) establish procedures for covered hospitals to 
                carry out the requirements of the Program described 
                under paragraph (3);
                    ``(C) make payments to covered hospitals for items 
                and services provided to qualified individuals in 
                accordance with subsection (b); and
                    ``(D) submit a report on the Program in accordance 
                with subsection (c).
            ``(2) Selection.--
                    ``(A) In general.--For purposes of this subsection, 
                a covered hospital is a hospital--
                            ``(i) that submits to the Secretary an 
                        application at such time, in such manner, and 
                        containing such information as the Secretary 
                        may require;
                            ``(ii) is selected by the Secretary to 
                        carry out the Program for not more than a 3-
                        year period; and
                            ``(iii) is a subsection (d) hospital under 
                        section 1886.
                    ``(B) Requirement.--The Secretary shall select at 
                least 20 covered hospitals located in at least 10 
                different States to carry out the Program.
            ``(3) Program requirements.--
                    ``(A) Staff.--A covered hospital shall maintain on 
                staff a physician, registered dietitian or nutrition 
                professional, or clinical social worker to--
                            ``(i) screen an individual that is an 
                        inpatient of such hospital with validated 
                        screening tools to determine whether such 
                        individual is a qualified individual;
                            ``(ii) re-screen each individual receiving 
                        medically tailored home-delivered meals with 
                        validated screening tools every 12 weeks to 
                        determine whether such individual is qualified 
                        to continue receiving medically tailored home-
                        delivered meals;
                            ``(iii) in the case such an individual is 
                        determined to be a qualified individual under 
                        clause (i) or (ii), ensure such individual 
                        receives medically tailored home-delivered 
                        meals pursuant to a contract described in 
                        subparagraph (B);
                            ``(iv) provide to such individual 
                        determined to be a qualified individual under 
                        clause (i) or (ii) medical nutrition therapy 
                        furnished by a registered dietitian or 
                        nutritional professional or ensure that the 
                        organization described in subparagraph (B) that 
                        delivers meals to such individual provides to 
                        such individual such therapy (as appropriate); 
                        and
                            ``(v) monitor the clinical health outcomes 
                        (based on measures developed by the Secretary 
                        consistent with State law) of each individual 
                        that receive medically tailored home-delivered 
                        meals.
                    ``(B) Contract to deliver meals.--
                            ``(i) In general.--A covered hospital shall 
                        enter into a contract (in accordance with 
                        criteria established by the Secretary) with at 
                        least 1 organization that has at least 1 year 
                        of experience preparing and delivering 
                        medically tailored meals similar to meals 
                        described in subsection (e)(2) and providing 
                        individual nutritional counseling or medical 
                        nutrition therapy in connection with delivering 
                        meals.
                            ``(ii) Number of meals.--The contract 
                        described in clause (i) shall provide for--
                                    ``(I) at least 2 medically tailored 
                                home-delivered meals (or a portioned 
                                equivalent) each day that meet at least 
                                two-thirds of the daily nutritional 
                                needs of the qualified individual; and
                                    ``(II) at least 12 weeks of 
                                medically tailored home-delivered 
                                meals.
                            ``(iii) Option to provide meals for 
                        caregivers or dependents under the age of 18.--
                        In the case an individual is determined to be a 
                        qualified individual under clause (i) or (ii) 
                        of subparagraph (A), the covered hospital may 
                        contract with the organization described in 
                        clause (i) to provide to the primary caregiver 
                        of the individual or a dependent under the age 
                        of 18 that resides in the household of such 
                        individual a meal the organization determines 
                        appropriate.
                    ``(C) Report by hospital.--Not later than 1 year 
                after the date the covered hospital begins to 
                participate in the Program, and annually thereafter, a 
                hospital selected under paragraph (2) shall submit to 
                the Secretary a report on--
                            ``(i) the impact of medically tailored 
                        home-delivered meals on clinical health 
                        outcomes described in subparagraph (A)(v);
                            ``(ii) the impact of medically tailored 
                        home-delivered meals on hospital costs 
                        (including the costs associated with the 
                        readmission (as defined in 1886(q)(5)(E)) of 
                        individuals); and
                            ``(iii) any other information necessary to 
                        evaluate the Program.
    ``(b) Payment.--Under the Program, payment for an item or service 
provided under this section shall be made from the Federal Hospital 
Insurance Trust Fund for the type, amount, frequency, and duration of 
such an item or service as the Secretary determines appropriate as if 
the item or service was payable under section 1886. Payment for a 
contract described in subsection (a)(3)(B) shall be made from the 
Federal Hospital Insurance Trust Fund for the amount the Secretary 
determines appropriate.
    ``(c) Report by Secretary.--Not later than 3 years after the date 
of the enactment of this Act, and 6 years after such date, 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 report 
on the Program. Such report shall include a summary of, evaluation of, 
and recommendations on whether to cover medically tailored home-
delivered meals as a benefit under this part.
    ``(d) Hearings.--
            ``(1) In general.--The Committee on Ways and Means of the 
        House of Representatives shall, not later than 90 days after 
        the date the Secretary submits a report under subsection (c), 
        hold a hearing on the recommendations submitted by the 
        Secretary under subsection (c).
            ``(2) Exercise of rulemaking authority.--Paragraph (1) is 
        enacted--
                    ``(A) as an exercise of rulemaking power of the 
                House of Representatives, and, as such, shall be 
                considered as part of the rules of the House, and such 
                rules shall supersede any other rule of the House only 
                to the extent that rule is inconsistent therewith; and
                    ``(B) with full recognition of the constitutional 
                right of either House to change such rules (so far as 
                relating to the procedure in such House) at any time, 
                in the same manner, and to the same extent as in the 
                case of any other rule of the House.
    ``(e) Definitions.--In this section:
            ``(1) Medical nutrition therapy.--The term `medical 
        nutrition therapy' means, for the purpose of disease 
        management, nutritional, diagnostics, and counseling, services 
        that are furnished by a registered dietitian or nutrition 
        professional.
            ``(2) Medically tailored home-delivered meal.--The term 
        `medically tailored home-delivered meal' means a meal that is 
        designed by a registered dietitian or nutritional 
        professional--
                    ``(A) for the treatment plan of a qualified 
                individual; and
                    ``(B) to improve health outcomes, lower the cost of 
                care, and increase the patient satisfaction of such 
                qualified individual.
            ``(3) Qualified individual.--The term `qualified 
        individual' means an individual who--
                    ``(A) is entitled to benefits under this part;
                    ``(B) has a diet-impacted disease (such as kidney 
                disease, congestive heart failure, diabetes, chronic 
                obstructive pulmonary disease, or any other disease the 
                Secretary determines appropriate) that is likely to 
                cause the individual to require care at a hospital; and
                    ``(C) has at least one activity of daily living 
                limitation.
            ``(4) Registered dietitian or nutrition professional.--The 
        term `dietitian or nutrition professional' has the meaning 
        given such term in section 1861(vv)(2).
            ``(5) Validated screening tool.--The term `validated 
        screening tool' means a questionnaire that has been 
        psychometrically tested for reliability and validity in 
        assessing the presence of a condition in the individual who is 
        screened by such questionnaire.''.
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