HR8923119th CongressWALLET

At HOME Services Act

Sponsored By: Representative Castor, Kathy [D-FL-14]

Introduced

Summary

Allows Medicare-covered hospital observation care to be delivered in patients' homes.

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This bill would create a two-year demonstration program that, within one year, would let participating hospitals furnish outpatient observation services in beneficiaries' homes and request specific waivers and flexibilities.

  • Medicare beneficiaries: Could receive hospital-level outpatient observation at home rather than in the hospital. The program would track outcomes such as readmission rates, mortality, infections, and patient experience.
  • Hospitals and providers: Could get waivers from 24-hour on-site nursing rules, certain physical environment and Life Safety Code requirements, and telehealth originating-site limits so the home counts as the originating site. Hospitals must meet Secretary-defined safety standards, report data, and may be removed from the program if they fail to comply.
  • CMS and researchers: The Secretary would collect data and conduct a study comparing home-based and hospital observation on quality, costs, the quantity and mix of services, and patient socioeconomic and demographic information. The Secretary must post a report on a CMS website within one year after the program ends.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Medicare observation care at home

This bill would create a two-year Medicare demonstration letting hospitals provide outpatient observation services in a beneficiary's home. The Secretary would have to start the program no later than 1 year after enactment. Hospitals would be allowed to join only if they request waivers and meet rules, such as ensuring the same standard of care at home as in the hospital, meeting patient-safety standards except for any waived requirements, and giving CMS required data in the time, form, and manner the Secretary sets. Participating hospitals would be allowed to use waivers like not having 24-hour on-site nursing, some Life Safety Code and physical environment rules, and allowing the home to be the telehealth originating site. The Secretary would study and compare care, costs, and who uses the program and post a report on a CMS website within 1 year after the program ends.

Sponsors & CoSponsors

Sponsor

Castor, Kathy [D-FL-14]

FL • D

Cosponsors

  • Rep. Buchanan, Vern [R-FL-16]

    FL • R

    Sponsored 5/20/2026

Roll Call Votes

No roll call votes available for this bill.

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