reintroduced the bipartisan At Home Observation and Medical Evaluation (HOME) Services Act to expand access to innovative health care models for Medicare patients under observation status... would direct the Centers for Medicare and Medicaid Services (CMS) to establish a two-year pilot program that allows hospitals to provide hospital-level care at home for eligible patients
Expand access to hospital-at-home care for Medicare patients under observation status through a bipartisan bill and a CMS pilot program.
Occurrences
Evidence
The bipartisan Senate bill text says it would amend the Social Security Act to extend acute hospital care at home waiver flexibilities to 2030 and require an HHS study. Congress.gov shows it was introduced on 2025-07-10 and remains in introduced status.
Section 6210 of the enacted law extends acute hospital care at home waiver flexibilities to September 30, 2030 and directs a later CMS study comparing emergency-department entrants with existing inpatient-stay entrants.
Congress.gov shows H.R.4313 passed the House on 2025-12-01 and was received in the Senate on 2025-12-02; the bill would extend acute hospital care at home waiver flexibilities to 2030 and require an additional study and report.
Section 6210 of the enacted Consolidated Appropriations Act of 2026 changes Social Security Act section 1866G(a)(1) by replacing "January 30, 2026" with "September 30, 2030" and adds a new study-and-report requirement for Acute Hospital Care at Home.
Assessments
Castor appears to have materially advanced the issue through bipartisan hospital-at-home legislation that passed the House, and Congress later enacted a same-term law extending hospital-at-home waiver flexibilities and requiring a federal study. That counts as meaningful delivery on expanding hospital-at-home access. But the enacted outcome did not specifically deliver the narrower promised expansion for Medicare patients under observation status, and it did not clearly create the promised CMS pilot program. Because the result was broader than, but short of, the specific promise, the best judgment is partial fulfillment in the same term.
A bipartisan hospital-at-home bill was introduced on 2025-07-10, but the bill remained in introduced status and did not itself deliver the promised expansion for Medicare patients under observation status. Congress later enacted a broader hospital-at-home extension on 2026-02-03 that pushed waiver flexibilities to September 30, 2030 and ordered a CMS study, but that did not specifically resolve the observation-status/pilot-program part of the promise. That is meaningful progress, but not full fulfillment of the stated pledge.