The "Medically Tailored Home-Delivered Meals Program Pilot Act" establishes a new 6-year program under Medicare Part A to test a payment and service delivery model. This program aims to improve clinical health outcomes and significantly reduce hospital readmission rates for specific Medicare beneficiaries by providing them with specialized nutritional support. Under the program, the Secretary will select at least 40 eligible hospitals by June 30, 2027. These hospitals must be either subsection (d) hospitals or critical access hospitals, meet specific quality ratings (at least 3 stars for subsection (d) hospitals), and satisfy program integrity requirements. Participating hospitals must attest to their capacity to furnish the required services, including providing qualified staff such as physicians or registered dietitians. Selected hospitals are responsible for screening inpatients using validated tools to identify qualified individuals and re-screening them every 12 weeks. A qualified individual is a Medicare Part A beneficiary with a diet-impacted disease, living at home, not in extended care or hospice, limited in at least two activities of daily living, and at high risk of readmission. These individuals will receive at least two medically tailored home-delivered meals daily for a minimum of 12 weeks, designed to meet two-thirds of their nutritional needs and cultural requirements. Additionally, they will receive medical nutrition therapy for a period of 12 weeks to one year. Payments to selected hospitals will be determined by the Secretary, with no cost-sharing for beneficiaries. The program is funded from the Federal Hospital Insurance Trust Fund, with a mandate for budget neutrality achieved by reducing other Medicare payments to subsection (d) hospitals. The Secretary will conduct intermediate and final evaluations of the program, assessing clinical outcomes, total cost of care, and patient experience, with reports submitted to Congress.