US Senators Move To Extend CMS’ Acute Hospital Care at Home Waiver With Bill Introduction

Sens. Tom Carper (D-Del.) and Tim Scott (R-S.C.) have introduced a bill that would push back the expiration date of the Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care at Home waiver program by five years. 

“Since Hospital at Home was implemented just a few years ago, we have seen this program deliver positive patient outcomes and reduce costs nationwide,” Carper said in a press statement.

Currently, the hospital-at-home waiver program is set to end on Dec. 31.


In 2020, CMS rolled out the Acute Hospital Care At Home program. The CMS waiver program was a response to the COVID-19 pandemic, and allowed providers to receive reimbursement for delivering hospital-level care in the home at a time when hospitals were struggling with capacity.

By creating a reimbursement mechanism, the waiver effectively addressed one of the biggest challenges to implementing hospital-at-home programs at-scale across the country.

As of May, 330 hospitals, across 136 systems, in 37 states have been approved to take part in the waiver program.


“The Acute Hospital Care at Home program has revolutionized health care for so many Americans by improving care while cutting down on the health risks associated with hospital stays,” Scott said in a press statement. “I’m proud of our efforts to extend this program, ease pressure on our health care system, and allow thousands of vulnerable Americans to continue receiving high quality care from the safety of their homes.”

This isn’t the first time that extending the waiver program has been on the table.

In 2022, the “Hospital Inpatient Services Modernization Act” was introduced. The legislation was, again, sponsored by Sens. Tom Carper (D-Del.) and Tim Scott (R-S.C.). Reps. Brad Wenstrup (R-Ohio) and Earl Blumenauer (D-Ore.) also sponsored this bill, which extended the waiver two more years.

What’s more, Sens. Marco Rubio (R-Fla.) and Tom Carper (D – Del.) also introduced the At Home Observation and Medical Evaluation (HOME) Services Act last month. The bill would expand the scope of hospital-at-home providers by allowing them to care for “observation status patients.”

“Addressing our health care challenges requires innovative solutions,” Rubio said in a press statement. “The HOME Services Act builds on the success of the hospital-at-home program to lower costs and burdens and improve patient outcomes and satisfaction.”

Aside from legislative action from policymakers, providers and other industry stakeholders have been vocal in their efforts to extend the waiver.

In March, a large group of hospital-at-home stakeholders penned a letter addressed to Senate majority leader and Senate minority leader – Sens. Chuck Schumer (D–N.Y.) and Mitch McConnell (R–Ky.).

The letter called for at least a 5-year extension of the waiver program before its expiration at the end of 2024.

“The waiver must be extended to enable hospitals and health systems nationwide to continue building out the logistics, supply chain, and workforce for hospital-at-home (HaH) and to encourage multiple payers outside the Medicare program, including Medicaid programs, to enter the HaH market,” the cohort wrote in the letter. “An extension will also allow home-based services to be developed equitably across populations everywhere and ensure hospital inpatient unit care is available for the patients who need it while enabling patients who can and want to be treated in their home to have the opportunity to do so, creating needed capacity for hospitals without increasing health system costs.”

The letter includes signatures from companies like ChristianaCare, CommonSpirit Health, Right at Home and Best Buy Health. Advocacy group Moving Health Home was also among those that signed the letter.

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