Medically Tailored Home-Delivered Meals Program Pilot Act
- Bill Number
- H.R. 5439
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-09-17: Referred to the House Committee on Ways and Means.
- Last Updated
- 2026-06-24T08:09:49Z
AI-Generated Summary
Purpose
The legislation, titled the "Medically Tailored Home-Delivered Meals Program Pilot Act" (H.R. 5439), aims to create a temporary pilot program under Medicare Part A (which covers hospital insurance) to test delivering customized meals to certain patients after hospital discharge. The goal is to improve their health results and lower the chances of returning to the hospital soon after leaving, by addressing nutrition needs tied to their medical conditions.
Key Provisions
- Program Setup: The U.S. Secretary of Health and Human Services (through the Centers for Medicare & Medicaid Services, or CMS) must start a 6-year pilot program no later than 30 months after the bill becomes law. It involves at least 40 selected hospitals providing services.
- Hospital Selection: Eligible hospitals include general acute care hospitals or critical access hospitals (smaller rural facilities). They must apply, show they can deliver the services (possibly through partnerships), have at least a 3-star quality rating from CMS for recent years, and meet fraud-prevention standards.
- Screening and Services:
- Hospitals screen patients during discharge planning using approved tools to identify "qualified individuals" (those with diet-related illnesses like diabetes or heart failure, living at home, limited in daily activities, at high risk of readmission, and not getting similar aid elsewhere).
- Qualified patients receive at least two home-delivered meals per day (or equivalent portions) for at least 12 weeks initially, and ongoing if re-screened every 12 weeks. Meals must cover two-thirds of daily nutrition and fit the patient's medical, allergy, or cultural needs.
- Patients also get medical nutrition therapy (personalized diet advice from a registered dietitian or similar expert) for 12 weeks to 1 year.
- Hospitals must staff or partner with professionals like doctors, dietitians, nurses, or social workers for screening and therapy.
- Payments and Costs: CMS sets payments to hospitals, considering rates from other insurers for similar services. No deductibles, copays, or other out-of-pocket costs apply to patients. Funding comes from Medicare's Hospital Insurance Trust Fund, with the program designed to be budget-neutral (savings from reduced hospital payments elsewhere offset costs).
- Monitoring and Reporting: CMS monitors patient data for health improvements. It will conduct mid-program (after 3 years) and final (after 8 years) evaluations, comparing outcomes like readmissions, total costs, and patient satisfaction to non-participants. Reports go to House and Senate committees overseeing health funding.
Significant Changes to Existing Law
This bill adds a new section (1866H) to Part E of title XVIII of the Social Security Act, which governs Medicare. It introduces a pilot for nutrition-focused post-discharge care under Part A, which previously did not cover home-delivered meals. Key additions include mandatory screening in discharge planning, no-cost access to tailored meals and therapy for qualifiers, and budget-neutral funding tied to adjustments in hospital payments under section 1886(d). It builds on existing definitions for medical nutrition therapy but expands their application to this meal delivery model.
Potential Impacts
- On Citizens: Qualifying Medicare patients (typically older adults or those with chronic conditions) could see better health management at home, fewer hospital readmissions, and improved quality of life through accessible, personalized nutrition without extra costs. It may reduce burdens on family caregivers.
- On Government Agencies: CMS gains responsibility for selecting hospitals, processing payments, monitoring data, and evaluating results, potentially informing future Medicare expansions if successful. The budget-neutral rule aims to avoid increasing overall Medicare spending, but implementation could strain administrative resources initially.
- On International Relations: No direct impacts, as this is a domestic healthcare program focused on U.S. Medicare beneficiaries.
Main Stakeholders Affected
- Medicare Beneficiaries: Especially those with diet-impacted chronic diseases, limited daily functioning, and high readmission risk, who stand to gain from free meals and therapy.
- Hospitals: Selected facilities (at least 40, including rural critical access ones) must invest in screening, staffing, and partnerships; they receive payments but face data reporting requirements.
- Healthcare Providers: Physicians, dietitians, nurses, and social workers involved in screening, meal planning, and therapy.
- CMS and HHS: Oversees program rollout, evaluations, and funding from the trust fund.
- Congress: Receives evaluation reports to assess expansion or modifications.
- Meal Providers and Suppliers: Entities partnering with hospitals to prepare and deliver meals, potentially benefiting from new contracts.
Notable Legal, Constitutional, or Political Implications
- Legal: The bill ensures compliance with existing Medicare rules on discharge planning and quality ratings, while adding safeguards like fraud checks and validated screening tools. Budget neutrality prevents unfunded mandates by linking costs to payment reductions elsewhere, aligning with federal budgeting laws.
- Constitutional: No apparent issues; it operates within Congress's authority to regulate interstate commerce and spending for public welfare under the Spending Clause.
- Political: Sponsored by bipartisan lawmakers (Democrats and Republicans), it emphasizes cost-saving healthcare innovations for vulnerable populations, potentially appealing across party lines. Success could influence broader debates on addressing social needs (like food insecurity) in Medicare, but failure might highlight challenges in pilot program scalability.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. McGovern, James P. [D-MA-2]
Cosponsors (30)
Rep. Malliotakis, Nicole [R-NY-11], Rep. Pingree, Chellie [D-ME-1], Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Evans, Dwight [D-PA-3], Rep. Sewell, Terri A. [D-AL-7], Rep. Moore, Gwen [D-WI-4], Rep. Goldman, Daniel S. [D-NY-10], Rep. Kennedy, Timothy M. [D-NY-26], Rep. Clarke, Yvette D. [D-NY-9], Rep. Lynch, Stephen F. [D-MA-8], Rep. Kamlager-Dove, Sydney [D-CA-37], Rep. Tlaib, Rashida [D-MI-12], Rep. DelBene, Suzan K. [D-WA-1], Rep. Watson Coleman, Bonnie [D-NJ-12], Rep. Moulton, Seth [D-MA-6], Rep. Lieu, Ted [D-CA-36], Rep. Carson, André [D-IN-7], Rep. Matsui, Doris O. [D-CA-7], Rep. McCollum, Betty [D-MN-4], Rep. Thompson, Mike [D-CA-4], Rep. Garbarino, Andrew R. [R-NY-2], Rep. Raskin, Jamie [D-MD-8], Rep. Cohen, Steve [D-TN-9], Rep. Davids, Sharice [D-KS-3], Rep. Williams, Nikema [D-GA-5], Rep. Torres, Ritchie [D-NY-15], Rep. Bonamici, Suzanne [D-OR-1], Rep. Vindman, Eugene Simon [D-VA-7], Rep. Lawler, Michael [R-NY-17], Del. Norton, Eleanor Holmes [D-DC-At Large]
Recent Actions
- 2025-09-17: Referred to the House Committee on Ways and Means.
- 2025-09-17: Introduced in House
- 2025-09-17: Sponsor introductory remarks on measure. (CR H4374-4375)
- 2025-09-17: Introduced in House
Bill Versions
- Medically Tailored Home-Delivered Meals Program Pilot Act — issued 2025-09-17 — PDF (11 pages)