Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 6774 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. IN THE HOUSE OF REPRESENTATIVES MAY 8, 2020 Mr. MCGOVERN (for himself, Ms. PINGREE, Mrs. WALORSKI, and Mr. MAR- SHALL) introduced the following bill; which was referred to the Com- mittee on Ways and Means, and in addition to the Committee on Rules, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL 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 hos- pital providing to qualified individuals medically tailored home-delivered meals, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Medically Tailored 4 Home-Delivered Meals Demonstration Pilot Act of 2020’’. 5 VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 6774 IH SEC. 2. MEDICALLY TAILORED HOME-DELIVERED MEALS 1 DEMONSTRATION PILOT PROGRAM. 2 (a) IN GENERAL.—Part A of title XVIII of the Social 3 Security Act (42 U.S.C. 1395 et seq.) is amended by add- 4 ing at the end the following new section: 5 ‘‘SEC. 1822. MEDICALLY TAILORED HOME-DELIVERED 6 MEALS DEMONSTRATION PILOT PROGRAM. 7 ‘‘(a) ESTABLISHMENT.— 8 ‘‘(1) IN GENERAL.—Not later than 1 year after 9 the date of the enactment of this Act, the Secretary 10 shall conduct under this section the Medically Tai- 11 lored Home-Delivered Meals Demonstration Pilot 12 Program (in this section referred to as the ‘Pro- 13 gram’) for a 3-year period to assess the effects of a 14 covered hospital providing to qualified individuals 15 medically tailored home-delivered meals. Under the 16 Program, the Secretary shall— 17 ‘‘(A) select eligible hospitals to participate 18 in the Program in accordance with paragraph 19 (2); 20 ‘‘(B) establish procedures for covered hos- 21 pitals to carry out the requirements of the Pro- 22 gram described under paragraph (3); 23 ‘‘(C) make payments to covered hospitals 24 for items and services provided to qualified indi- 25 viduals in accordance with subsection (b); and 26 VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 6774 IH ‘‘(D) submit a report on the Program in 1 accordance with subsection (c). 2 ‘‘(2) SELECTION.— 3 ‘‘(A) IN GENERAL.—For purposes of this 4 subsection, a covered hospital is a hospital— 5 ‘‘(i) that submits to the Secretary an 6 application at such time, in such manner, 7 and containing such information as the 8 Secretary may require; 9 ‘‘(ii) is selected by the Secretary to 10 carry out the Program for not more than 11 a 3-year period; and 12 ‘‘(iii) is a subsection (d) hospital 13 under section 1886. 14 ‘‘(B) REQUIREMENT.—The Secretary shall 15 select at least 20 covered hospitals located in at 16 least 10 different States to carry out the Pro- 17 gram. 18 ‘‘(3) PROGRAM REQUIREMENTS.— 19 ‘‘(A) STAFF.—A covered hospital shall 20 maintain on staff a physician, registered dieti- 21 tian or nutrition professional, or clinical social 22 worker to— 23 ‘‘(i) screen an individual that is an in- 24 patient of such hospital with validated 25 VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 6774 IH screening tools to determine whether such 1 individual is a qualified individual; 2 ‘‘(ii) re-screen each individual receiv- 3 ing medically tailored home-delivered meals 4 with validated screening tools every 12 5 weeks to determine whether such indi- 6 vidual is qualified to continue receiving 7 medically tailored home-delivered meals; 8 ‘‘(iii) in the case such an individual is 9 determined to be a qualified individual 10 under clause (i) or (ii), ensure such indi- 11 vidual receives medically tailored home-de- 12 livered meals pursuant to a contract de- 13 scribed in subparagraph (B); 14 ‘‘(iv) provide to such individual deter- 15 mined to be a qualified individual under 16 clause (i) or (ii) medical nutrition therapy 17 furnished by a registered dietitian or nutri- 18 tional professional or ensure that the orga- 19 nization described in subparagraph (B) 20 that delivers meals to such individual pro- 21 vides to such individual such therapy (as 22 appropriate); and 23 ‘‘(v) monitor the clinical health out- 24 comes (based on measures developed by 25 VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 6774 IH the Secretary consistent with State law) of 1 each individual that receive medically tai- 2 lored home-delivered meals. 3 ‘‘(B) CONTRACT TO DELIVER MEALS.— 4 ‘‘(i) IN GENERAL.—A covered hospital 5 shall enter into a contract (in accordance 6 with criteria established by the Secretary) 7 with at least 1 organization that has at 8 least 1 year of experience preparing and 9 delivering medically tailored meals similar 10 to meals described in subsection (e)(2) and 11 providing individual nutritional counseling 12 or medical nutrition therapy in connection 13 with delivering meals. 14 ‘‘(ii) NUMBER OF MEALS.—The con- 15 tract described in clause (i) shall provide 16 for— 17 ‘‘(I) at least 2 medically tailored 18 home-delivered meals (or a portioned 19 equivalent) each day that meet at 20 least two-thirds of the daily nutri- 21 tional needs of the qualified indi- 22 vidual; and 23 ‘‘(II) at least 12 weeks of medi- 24 cally tailored home-delivered meals. 25 VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 6774 IH ‘‘(iii) OPTION TO PROVIDE MEALS FOR 1 CAREGIVERS OR DEPENDENTS UNDER THE 2 AGE OF 18.—In the case an individual is 3 determined to be a qualified individual 4 under clause (i) or (ii) of subparagraph 5 (A), the covered hospital may contract with 6 the organization described in clause (i) to 7 provide to the primary caregiver of the in- 8 dividual or a dependent under the age of 9 18 that resides in the household of such in- 10 dividual a meal the organization deter- 11 mines appropriate. 12 ‘‘(C) REPORT BY HOSPITAL.—Not later 13 than 1 year after the date the covered hospital 14 begins to participate in the Program, and annu- 15 ally thereafter, a hospital selected under para- 16 graph (2) shall submit to the Secretary a report 17 on— 18 ‘‘(i) the impact of medically tailored 19 home-delivered meals on clinical health 20 outcomes described in subparagraph 21 (A)(v); 22 ‘‘(ii) the impact of medically tailored 23 home-delivered meals on hospital costs (in- 24 cluding the costs associated with the read- 25 VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 6774 IH mission (as defined in 1886(q)(5)(E)) of 1 individuals); and 2 ‘‘(iii) any other information necessary 3 to evaluate the Program. 4 ‘‘(b) PAYMENT.—Under the Program, payment for 5 an item or service provided under this section shall be 6 made from the Federal Hospital Insurance Trust Fund 7 for the type, amount, frequency, and duration of such an 8 item or service as the Secretary determines appropriate 9 as if the item or service was payable under section 1886. 10 Payment for a contract described in subsection (a)(3)(B) 11 shall be made from the Federal Hospital Insurance Trust 12 Fund for the amount the Secretary determines appro- 13 priate. 14 ‘‘(c) REPORT BY SECRETARY.—Not later than 3 15 years after the date of the enactment of this Act, and 6 16 years after such date, the Secretary shall submit to the 17 Committee on Ways and Means of the House of Rep- 18 resentatives and the Committee on Finance of the Senate 19 a report on the Program. Such report shall include a sum- 20 mary of, evaluation of, and recommendations on whether 21 to cover medically tailored home-delivered meals as a ben- 22 efit under this part. 23 ‘‘(d) HEARINGS.— 24 VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 6774 IH ‘‘(1) IN GENERAL.—The Committee on Ways 1 and Means of the House of Representatives shall, 2 not later than 90 days after the date the Secretary 3 submits a report under subsection (c), hold a hear- 4 ing on the recommendations submitted by the Sec- 5 retary under subsection (c). 6 ‘‘(2) EXERCISE OF RULEMAKING AUTHORITY.— 7 Paragraph (1) is enacted— 8 ‘‘(A) as an exercise of rulemaking power of 9 the House of Representatives, and, as such, 10 shall be considered as part of the rules of the 11 House, and such rules shall supersede any other 12 rule of the House only to the extent that rule 13 is inconsistent therewith; and 14 ‘‘(B) with full recognition of the constitu- 15 tional right of either House to change such 16 rules (so far as relating to the procedure in 17 such House) at any time, in the same manner, 18 and to the same extent as in the case of any 19 other rule of the House. 20 ‘‘(e) DEFINITIONS.—In this section: 21 ‘‘(1) MEDICAL NUTRITION THERAPY.—The 22 term ‘medical nutrition therapy’ means, for the pur- 23 pose of disease management, nutritional, diagnostics, 24 VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 6774 IH and counseling, services that are furnished by a reg- 1 istered dietitian or nutrition professional. 2 ‘‘(2) MEDICALLY TAILORED HOME-DELIVERED 3 MEAL.—The term ‘medically tailored home-delivered 4 meal’ means a meal that is designed by a registered 5 dietitian or nutritional professional— 6 ‘‘(A) for the treatment plan of a qualified 7 individual; and 8 ‘‘(B) to improve health outcomes, lower the 9 cost of care, and increase the patient satisfac- 10 tion of such qualified individual. 11 ‘‘(3) QUALIFIED INDIVIDUAL.—The term ‘quali- 12 fied individual’ means an individual who— 13 ‘‘(A) is entitled to benefits under this part; 14 ‘‘(B) has a diet-impacted disease (such as 15 kidney disease, congestive heart failure, diabe- 16 tes, chronic obstructive pulmonary disease, or 17 any other disease the Secretary determines ap- 18 propriate) that is likely to cause the individual 19 to require care at a hospital; and 20 ‘‘(C) has at least one activity of daily living 21 limitation. 22 ‘‘(4) REGISTERED DIETITIAN OR NUTRITION 23 PROFESSIONAL.—The term ‘dietitian or nutrition 24 VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 6774 IH professional’ has the meaning given such term in 1 section 1861(vv)(2). 2 ‘‘(5) VALIDATED SCREENING TOOL.—The term 3 ‘validated screening tool’ means a questionnaire that 4 has been psychometrically tested for reliability and 5 validity in assessing the presence of a condition in 6 the individual who is screened by such question- 7 naire.’’. 8 Æ VerDate Sep 11 2014 01:34 May 21, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\H6774.IH H6774 pamtmann on DSKBC07HB2PROD with BILLS