Hospital Inpatient Services Modernization Act
Click any stage to learn more about the legislative process.
Would extend the Medicare Acute Hospital Care at Home program through September 2030, preserving hospitals' ability to treat qualifying inpatient-level patients in their homes rather than a hospital facility.
It would also mandate a comprehensive study comparing home-hospital care to traditional inpatient settings across quality, cost, and patient demographics, with findings reported to Congress — giving lawmakers data to decide the program's long-term future.
What this bill would do
What it would do
The bill would extend the waiver authority for the Medicare Acute Hospital Care at Home initiative — which allows hospitals to treat certain patients from emergency departments or inpatient beds at home — from January 30, 2026, through September 30, 2030. Without the extension, the program would expire in early 2026. The bill would also direct the Centers for Medicare & Medicaid Services (CMS) to conduct a new study by September 30, 2028, examining how home-based hospital care compares to traditional inpatient care across a detailed range of metrics: health outcomes, readmission and mortality rates, staffing, costs, service intensity, and the socioeconomic and demographic profile of patients served.
The bill would not create a new program or expand eligibility; it simply continues the existing initiative and funds a study. It would reduce the Medicare Improvement Fund by $2.5 million to offset the cost of the study appropriation, keeping the net budget impact neutral.
Key provisions
- 1Would extend the Acute Hospital Care at Home waiver authority under Medicare from January 30, 2026, through September 30, 2030, preserving hospital eligibility to treat qualifying patients at home.
- 2Would require CMS to conduct a subsequent study comparing quality of care, health outcomes, hospital readmission and mortality rates, costs, staffing, and service intensity between home-based and inpatient care.
- 3Would require the study to analyze patient demographics including race, ethnicity, income, housing, geography, and dual Medicare-Medicaid eligibility, to assess equity in program participation.
- 4Would require the Secretary of HHS to submit a report on study findings to the House Committee on Ways and Means and the Senate Committee on Finance no later than September 30, 2028.
- 5Would appropriate $2,500,000 to the CMS Program Management Account for FY2026 to fund the study, and would reduce the Medicare Improvement Fund by $2.5 million to offset that cost.
Who would be affected
Hospitals currently participating in or seeking to join the Acute Hospital Care at Home initiative, their patients who receive inpatient-level care at home under Medicare, and family members or caregivers who support those patients. CMS would bear the obligation to conduct and report the study. Committees on Ways and Means and Finance would receive the findings.
Why it matters
Without this extension, participating hospitals would lose their waiver authority to treat Medicare patients at home at inpatient reimbursement rates when the program expires in early 2026. The required study would produce the first systematic federal comparison of home-hospital and traditional inpatient care, shaping future decisions about whether and how to permanently authorize the program.
What would change
Changes to existing law
Amends Social Security Act, Section 1866G (42 U.S.C. 1395cc-7) (Sec. 2–3)
Extends program expiration from January 30, 2026, to September 30, 2030, and adds a new required subsequent study and report with detailed comparison metrics.
Amends Social Security Act, Section 1898(b)(1) (42 U.S.C. 1395iii(b)(1)) — Medicare Improvement Fund (Sec. 4)
Reduces the fund balance from $1,403,000,000 to $1,400,500,000 to offset the $2.5 million study appropriation.
Agencies directed to act
Effective dates
- Extended program expiration date — waiver authority continues through this date
- Study and report to Congress on the Acute Hospital Care at Home initiative due
- $2.5 million CMS Program Management Account appropriation for the study
Funding and costs
- $2,500,000
CMS Program Management Account funding to conduct the Acute Hospital Care at Home study
How implementation would work
CMS would administer the extended program under existing rules and conduct the new study using $2.5 million in dedicated appropriations. The agency may collect data through hospital cost reports, survey instruments it develops, medical records, or other means it deems appropriate. The study must control for selection bias when comparing participants and non-participants. Both the completed study and a formal report must be submitted to the House Ways and Means Committee and the Senate Finance Committee no later than September 30, 2028.
Legislative status & sources
Latest action
Received in the Senate and Read twice and referred to the Committee on Finance.
Official CRS summary
Show the CRS summaryHide the CRS summary
This bill extends the Acute Hospital Care at Home Program under Medicare and requires an additional study regarding the program. The program allows hospitals to treat certain patients from emergency departments or inpatient hospital beds at home.
Specifically, the bill extends the program through FY2030 and requires the Centers for Medicare & Medicaid Services to conduct a study of the program with respect to several metrics, including the quality of care, incurred costs, types of services, and demographics of patients under the program compared to inpatient settings.
Legislative subjects
Congressional oversight; Government studies and investigations; Health; Hospital care; Medicare
Committee report
H. Rept. 119-359