[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7742 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 7742
To amend title XVIII of the Social Security Act to establish a 2-year
demonstration program for hospitals to provide outpatient observation
services to Medicare beneficiaries at home.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 20, 2024
Ms. Castor of Florida (for herself and Mr. Buchanan) introduced the
following bill; which was referred to the Committee on Ways and Means,
and in addition to the Committee on Energy and Commerce, 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
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A BILL
To amend title XVIII of the Social Security Act to establish a 2-year
demonstration program for hospitals to provide outpatient observation
services to Medicare beneficiaries at home.
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 ``At Home Observation and Medical
Evaluation Services Act of 2024'' or the ``At HOME Services Act''.
SEC. 2. DEMONSTRATION PROGRAM FOR HOSPITALS TO PROVIDE OUTPATIENT
OBSERVATION SERVICES TO MEDICARE BENEFICIARIES AT HOME.
Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is
amended by inserting after section 1866G the following new section:
``SEC. 1866H. DEMONSTRATION PROGRAM FOR HOSPITALS TO PROVIDE OUTPATIENT
OBSERVATION SERVICES AT HOME.
``(a) In General.--Not later than 1 year after the date of
enactment of this section, the Secretary shall implement a 2-year
demonstration program (in this section referred to as the `Program')
for hospitals to provide outpatient observation services to eligible
beneficiaries in the homes of such beneficiaries. In implementing such
Program, the Secretary shall grant waivers and flexibilities (as
described in subsection (b)) to an individual hospital that submits a
request for such waivers and flexibilities and meets specified criteria
(as described in subsection (c)) in order to participate in the
Program.
``(b) Waivers and Flexibilities.--For the purposes of subsection
(a), the waivers and flexibilities described in this paragraph are the
following waivers and flexibilities that were made available to
individual hospitals under the Acute Hospital Care at Home initiative
of the Secretary during the emergency period described in section
1135(g)(1)(B):
``(1) Subject to subsection (c)(2), waiver of the
requirements to provide 24-hour nursing services on premises
and for the immediate availability of a registered nurse under
section 482.23(b) of title 42, Code of Federal Regulations (or
any successor regulation), and the waivers of the physical
environment and Life Safety Code requirements under section
482.41 of title 42, Code of Federal Regulations (or any
successor regulation).
``(2) Waiver of the telehealth requirements under clause
(i) of section 1834(m)(4)(C), as amended by section 4113(a) of
the Health Extenders, Improving Access to Medicare, Medicaid,
and CHIP, and Strengthening Public Health Act of 2022, such
that the originating sites described in clause (ii) of such
section shall include the home or temporary residence of the
individual.
``(3) Other waivers and flexibilities that, as of the date
of enactment of this section, were in place for such initiative
during such emergency period.
``(c) Specified Criteria.--For purposes of subsection (a), the
specified criteria for granting such waivers and flexibilities to
individual hospitals are:
``(1) The hospital and any other entities providing
services under arrangements with the hospital shall ensure that
the standard of care to treat an eligible beneficiary at home
is the same as the standard of care to treat such beneficiary
as an inpatient of the hospital.
``(2) The hospital shall meet all patient safety standards
determined appropriate by the Secretary, in addition to those
that otherwise apply to the hospital, except those for which
the waivers and flexibilities under this subsection apply.
``(3) The hospital shall provide to the Secretary, at a
time, form and manner determined by the Secretary, any data and
information the Secretary determines necessary to do the
following:
``(A) Monitor the quality of care furnished, and to
the extent practicable ensure the safety of, eligible
beneficiaries and analyze costs of such care.
``(B) Undertake the study described in subsection
(e).
``(4) The hospital meets such other requirements and
conditions as the Secretary determines appropriate.
``(d) Termination.--The Secretary may terminate a hospital from
participation in the Program (and the waivers and flexibilities
applicable to such hospital) if the Secretary determines that the
hospital no longer meets the criteria described in subsection (c).
``(e) Study and Report.--
``(1) In general.--The Secretary shall conduct a study to--
``(A) analyze, to the extent practicable, the
criteria established by hospitals to determine which
beneficiaries may be furnished services under the
Program; and
``(B) analyze and compare, to the extent
practicable--
``(i) the quality of care furnished to
beneficiaries with similar conditions and
characteristics in the hospital setting and
through the Program, including health outcomes,
hospital readmission rates, hospital mortality
rates, length of stay, infection rates, and
patient experience of care;
``(ii) clinical conditions treated and
diagnosis-related groups of discharges from the
hospital setting and under the Program;
``(iii) costs incurred by furnishing care
in the hospital setting and through the
Program;
``(iv) the quantity, mix and intensity of
such services (such as in-person visits and
virtual contacts with patients) furnished under
the Program and furnished in the hospital
setting; and
``(v) socioeconomic information on
beneficiaries treated under the Program,
including racial and ethnic data, income, and
whether such beneficiaries are dually eligible
for benefits under this title and title XIX.
``(2) Report.--Not later than 1 year after the completion
of the Program, the Secretary shall post on a website of the
Centers for Medicare & Medicaid Services a report on the study
conducted under paragraph (1).
``(f) Implementation.--Notwithstanding any other provision of law,
the Secretary may implement this section by program instruction or
otherwise.
``(g) Publicly Available Information.--The Secretary shall, as
feasible, make the information collected under subsections (c)(3) and
(e)(1) available on the Medicare.gov Internet website (or a successor
website).''.
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