Medicare at Home Act

This legislation, known as the "Medicare at Home Act," seeks to amend the Social Security Act by establishing a new Medicare home care benefit . This benefit is designed to address the current gap in Medicare coverage for long-term personal care in the home, which often forces beneficiaries to pay out-of-pocket or forgo needed assistance. The bill defines "home care services" to include assistance with activities of daily living , such as bathing and dressing, and instrumental activities of daily living , like meal preparation and medication reminders. These services are capped at 20 hours per week per individual and are distinct from existing home health services. Eligibility requires beneficiaries to be enrolled in Medicare Part A or B, and a physician must certify their need for assistance with at least two daily living activities or one of each category. A key provision mandates that home care services be furnished under a plan of care established and periodically reviewed by a physician. The bill also directs the Secretary of Health and Human Services to establish a payment methodology for these services, ensuring a reasonable wage floor for home care workers . This aims to support the workforce providing these essential services. To finance the new benefit, the bill requires an adjustment to Medicare Part B premiums to reflect the additional actuarial cost, with an actuarial report to Congress on the per-beneficiary premium impact. The Secretary is also tasked with promulgating necessary regulations within one year of enactment, including standards for home care worker qualifications and agency enrollment, with the benefit becoming effective more than two years after enactment.