---
kind: "section"
citation: "42 U.S.C. § 1395cc–7"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1395cc–7"
heading: "Extension of Acute Hospital Care at Home initiative"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1395cc-7"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XVIII — Health Insurance for Aged and Disabled"
  - "Part E — Miscellaneous Provisions"
---

# §1395cc–7. Extension of Acute Hospital Care at Home initiative

- (a) **In general—**
  - (1) **Extension—** With respect to inpatient [hospital](/usc/42/1395x.md?p=e) admissions occurring during the period beginning on the first day after the end of the emergency period described in [section 1320b–5(g)(1)(B) of this title](/usc/42/1320b–5.md?p=g-1-B) and ending on September 30, 2030, the [Secretary](/usc/42/1301.md?p=a-6) of Health and Human Services shall [grant](/usc/42/1397j.md?p=10) waivers and flexibilities (as described in [paragraph (2)](#a-2)) to an individual [hospital](/usc/42/1395x.md?p=e) that submits a request for such waivers and flexibilities and meets specified criteria (as described in [paragraph (3)](#a-3)) in order to participate in the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative of the [Secretary](/usc/42/1301.md?p=a-6).
  - (2) **Acute Hospital Care at Home waivers and flexibilities—** For the purposes of [paragraph (1)](#a-1), the waivers and flexibilities described in this paragraph are the following waivers and flexibilities that were made available to individual [hospitals](/usc/42/1395x.md?p=e) under the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative of the [Secretary](/usc/42/1301.md?p=a-6) during the emergency period described in [section 1320b–5(g)(1)(B) of this title](/usc/42/1320b–5.md?p=g-1-B):
    - (A) Subject to [paragraph (3)(D)](#a-3-D), waiver of the requirements to provide 24-hour nursing services on premises and for the immediate availability of a registered nurse under section 482.23(b) of title 42, Code of Federal Regulations (or any successor regulation), and the waivers of the [physical](/usc/42/1395x.md?p=g) environment and Life Safety Code requirements under section 482.41 of title 42, Code of Federal Regulations (or any successor regulation).
    - (B) Flexibility to allow a [hospital](/usc/42/1395x.md?p=e) to furnish inpatient services, [including](/usc/42/1301.md?p=b) routine services, outside the [hospital](/usc/42/1395x.md?p=e) under [arrangements](/usc/42/1395x.md?p=w-1), as described in Medicare Program: [Hospital](/usc/42/1395x.md?p=e) Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; [Rural Emergency Hospitals](/usc/42/1395x.md?p=kkk-2): Payment Policies, Conditions of Participation, Provider Enrollment, [Physician](/usc/42/1395x.md?p=r) Self-Referral; New Service Category for [Hospital](/usc/42/1395x.md?p=e) Outpatient Department Prior Authorization Process; Overall [Hospital](/usc/42/1395x.md?p=e) Quality Star Rating; COVID–19 (87 Fed. Reg. 71748 et seq.).
    - (C) Waiver of the telehealth requirements under clause (i)[^1] of [section 1395m(m)(4)(C) of this title](/usc/42/1395m.md?p=m-4-C), as amended by section 4113(a) of the Health Extenders, Improving Access to Medicare, Medicaid, and CHIP, and Strengthening Public Health Act of 2022, such that the originating sites described in [clause (ii)](/usc/42/1395m.md?p=m-4-C-ii) of such section shall include the [home](/usc/42/1395x.md?p=iii-3-B) or temporary residence of the individual.
    - (D) Other waivers and flexibilities that, as of December 29, 2022, were in place for such initiative during such emergency period.
  - (3) **Specified criteria—** For purposes of [paragraph (1)](#a-1), the specified criteria for granting such waivers and flexibilities to individual [hospitals](/usc/42/1395x.md?p=e) are:
    - (A) The [hospital](/usc/42/1395x.md?p=e) shall indicate to the [Secretary](/usc/42/1301.md?p=a-6) the criteria it would use to ensure that [hospital](/usc/42/1395x.md?p=e) services be furnished only to an individual who requires an inpatient level of care, and shall require that a [physician](/usc/42/1395x.md?p=r) document in the medical record of each such individual that the individual meets such criteria.
    - (B) The [hospital](/usc/42/1395x.md?p=e) and any other entities providing services under [arrangements](/usc/42/1395x.md?p=w-1) with the [hospital](/usc/42/1395x.md?p=e) shall ensure that the [standard](/usc/42/1320d.md?p=7) of care to treat an individual at [home](/usc/42/1395x.md?p=iii-3-B) is the same as the [standard](/usc/42/1320d.md?p=7) of care to treat such individual as an inpatient of the [hospital](/usc/42/1395x.md?p=e).
    - (C) The [hospital](/usc/42/1395x.md?p=e) shall ensure that an individual is only eligible for services under [paragraph (1)](#a-1) if the individual is a [hospital](/usc/42/1395x.md?p=e) inpatient or is a patient of the [hospital](/usc/42/1395x.md?p=e)’s emergency department for whom the [hospital](/usc/42/1395x.md?p=e) determines that an inpatient level of care is required (as described in [subparagraph (A)](#a-3-A)).
    - (D) The [hospital](/usc/42/1395x.md?p=e) shall meet all patient safety [standards](/usc/42/1320d.md?p=7) determined appropriate by the [Secretary](/usc/42/1301.md?p=a-6), in addition to those that otherwise apply to the [hospital](/usc/42/1395x.md?p=e), except those for which the waivers and flexibilities under this subsection apply.
    - (E) The [hospital](/usc/42/1395x.md?p=e) shall provide to the [Secretary](/usc/42/1301.md?p=a-6), at a time, form and manner determined by the [Secretary](/usc/42/1301.md?p=a-6), any data and information the [Secretary](/usc/42/1301.md?p=a-6) determines necessary to do the following:
      - (i) Monitor the quality of care furnished, and to the extent practicable, ensure the safety of individuals and analyze costs of such care.
      - (ii) Undertake the studies described in subsections [(b)](#b) and [(c)](#c).

      The [Secretary](/usc/42/1301.md?p=a-6) may require that such data and information be submitted through a [hospital](/usc/42/1395x.md?p=e)’s cost report, through such survey instruments as the [Secretary](/usc/42/1301.md?p=a-6) may develop, through medical record information, or through such other means as the [Secretary](/usc/42/1301.md?p=a-6) determines appropriate.

    - (F) The [hospital](/usc/42/1395x.md?p=e) meets such other requirements and conditions as the [Secretary](/usc/42/1301.md?p=a-6) determines appropriate.
  - (4) **Termination—** The [Secretary](/usc/42/1301.md?p=a-6) may terminate a [hospital](/usc/42/1395x.md?p=e) from participation in such initiative (and the waivers and flexibilities applicable to such [hospital](/usc/42/1395x.md?p=e)) if the [Secretary](/usc/42/1301.md?p=a-6) determines that the [hospital](/usc/42/1395x.md?p=e) no longer meets the criteria described in [paragraph (3)](#a-3).
- (b) **Initial Study and report—**
  - (1) **In general—** The [Secretary](/usc/42/1301.md?p=a-6) shall conduct a study to—
    - (A) analyze, to the extent practicable, the criteria established by [hospitals](/usc/42/1395x.md?p=e) under the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative of the [Secretary](/usc/42/1301.md?p=a-6) to determine which individuals may be furnished services under such initiative; and
    - (B) analyze and compare, to the extent practicable—
      - (i) quality of care furnished to individuals with similar conditions and characteristics in the inpatient setting and through the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative, [including](/usc/42/1301.md?p=b) health outcomes, [hospital](/usc/42/1395x.md?p=e) readmission rates, [hospital](/usc/42/1395x.md?p=e) mortality rates, length of stay, infection rates, and patient experience of care;
      - (ii) clinical conditions treated and diagnosis-related groups of discharges from the inpatient setting and under the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative;
      - (iii) costs incurred by furnishing care in the inpatient setting and through the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative;
      - (iv) the quantity, mix and intensity of such services (such as in-[person](/usc/42/1301.md?p=a-3) visits and virtual contacts with patients) furnished in the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative and furnished in the inpatient setting; and
      - (v) socioeconomic information on beneficiaries treated under the initiative, [including](/usc/42/1301.md?p=b) racial and ethnic data, income, and whether such beneficiaries are dually eligible for benefits under this subchapter and subchapter XIX.
  - (2) **Report—** Not later than September 30, 2024, the [Secretary](/usc/42/1301.md?p=a-6) of Health and Human Services shall post on a website of the Centers for Medicare & Medicaid Services a report on the study conducted under [paragraph (1)](#b-1).
  - (3) **Funding—** In addition to amounts otherwise available, there is appropriated to the Centers for Medicare & Medicaid Services Program Management Account for [fiscal year](/usc/42/619.md?p=3) 2023, out of any amounts in the Treasury not otherwise appropriated, $5,000,000, to remain available until expended, for purposes of carrying out this section.
- (c) **Subsequent study and report—**
  - (1) **In general—** Not later than September 30, 2029, the [Secretary](/usc/42/1301.md?p=a-6) shall conduct a study to—
    - (A) analyze, to the extent practicable, the criteria established by [hospitals](/usc/42/1395x.md?p=e) under the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative to determine which individuals may be furnished services under such initiative; and
    - (B) analyze and compare (both within and between [hospitals](/usc/42/1395x.md?p=e) participating in the initiative, and relative to comparable [hospitals](/usc/42/1395x.md?p=e) that do not participate in the initiative, for relevant parameters such as diagnosis-related groups)—
      - (i) quality of care furnished to individuals with similar conditions and characteristics in the inpatient setting and through the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative, [including](/usc/42/1301.md?p=b) health outcomes, [hospital](/usc/42/1395x.md?p=e) readmission rates ([including](/usc/42/1301.md?p=b) readmissions both within and beyond 30 days post-discharge), [hospital](/usc/42/1395x.md?p=e) mortality rates, length of stay, infection rates, composition of care team ([including](/usc/42/1301.md?p=b) the types of labor used, such as contracted labor), the ratio of nursing staff, transfers from the [hospital](/usc/42/1395x.md?p=e) to the [home](/usc/42/1395x.md?p=iii-3-B), transfers from the [home](/usc/42/1395x.md?p=iii-3-B) to the [hospital](/usc/42/1395x.md?p=e) ([including](/usc/42/1301.md?p=b) the timing, frequency, and causes of such transfers), transfers and discharges to post-acute care settings ([including](/usc/42/1301.md?p=b) the timing, frequency, and causes of such transfers and discharges), and patient and [caregiver](/usc/42/1397j.md?p=3) experience of care;
      - (ii) clinical conditions treated and diagnosis-related groups of discharges from inpatient settings relative to discharges from the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative;
      - (iii) costs incurred by the [hospital](/usc/42/1395x.md?p=e) for furnishing care in inpatient settings relative to costs incurred by the [hospital](/usc/42/1395x.md?p=e) for furnishing care through the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative, [including](/usc/42/1301.md?p=b) costs relating to staffing, equipment, food, prescriptions, and other services, as determined by the [Secretary](/usc/42/1301.md?p=a-6);
      - (iv) the quantity, mix, and intensity of services (such as in-[person](/usc/42/1301.md?p=a-3) visits and virtual contacts with patients and the intensity of such services) furnished in inpatient settings relative to the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative, and, to the extent practicable, the nature and extent of family or [caregiver](/usc/42/1397j.md?p=3) involvement;
      - (v) socioeconomic information on individuals treated in comparable inpatient settings relative to the initiative, [including](/usc/42/1301.md?p=b) racial and ethnic data, income, housing, geographic proximity to the brick-and-mortar [facility](/usc/42/1320a–3.md?p=c-5-B) and whether such individuals are dually eligible for benefits under this subchapter and subchapter XIX; and
      - (vi) the quality of care, outcomes, costs, quantity and intensity of services, and other relevant metrics between individuals who entered into the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative directly from an emergency department compared with individuals who entered into the Acute [Hospital](/usc/42/1395x.md?p=e) Care at [Home](/usc/42/1395x.md?p=iii-3-B) initiative directly from an existing inpatient stay in a [hospital](/usc/42/1395x.md?p=e).
  - (2) **Selection bias—** In conducting the study under [paragraph (1)](#c-1), the [Secretary](/usc/42/1301.md?p=a-6) shall, to the extent practicable, analyze and compare individuals who participate and do not participate in the initiative controlling for selection bias or other factors that may impact the reliability of data.
  - (3) **Report—** Not later than September 30, 2029, the [Secretary](/usc/42/1301.md?p=a-6) of Health and Human Services shall—
    - (A) submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report on the study conducted under [paragraph (1)](#c-1); and
    - (B) make such report publicly available on a website of the Centers for Medicare & Medicaid Services.
  - (4) **Funding—** In addition to amounts otherwise available, there is appropriated to the Centers for Medicare & Medicaid Services Program Management Account for [fiscal year](/usc/42/619.md?p=3) 2026, out of any amounts in the Treasury not otherwise appropriated, $2,500,000, to remain available until expended, for purposes of carrying out this section.
- (d) **Implementation—** Notwithstanding any other provision of law, the [Secretary](/usc/42/1301.md?p=a-6) may implement this section by program instruction or otherwise.
- (e) **Publicly available information—** The [Secretary](/usc/42/1301.md?p=a-6) shall, as feasible, make the information collected under subsections [(a)(3)(E)](#a-3-E), [(b)(1)](#b-1), and [(c)(1)](#c-1) available on the Medicare.gov internet website (or a successor website).

## Footnotes

[^1]: So in original. Probably should be “clause (iii)”. See References in Text note below.

## Source credit

(Aug. 14, 1935, ch. 531, title XVIII, § 1866G, as added Pub. L. 117–328, div. FF, title IV, § 4140, Dec. 29, 2022, 136 Stat. 5926; amended Pub. L. 118–158, div. C, title II, § 3208, Dec. 21, 2024, 138 Stat. 1766; Pub. L. 119–4, div. B, title II, § 2208, Mar. 15, 2025, 139 Stat. 44; Pub. L. 119–37, div. F, title II, § 6204, Nov. 12, 2025, 139 Stat. 632; Pub. L. 119–75, div. J, title II, § 6210, Feb. 3, 2026, 140 Stat. 650.)

## Notes

### Editorial Notes

### References in Text

Section 4113(a) of the Health Extenders, Improving Access to Medicare, Medicaid, and CHIP, and Strengthening Public Health Act of 2022, referred to in subsec. (a)(2)(C), is section 4113(a) of div. FF of Pub. L. 117–328, which amended subsec. (m)(2)(B)(iii), (4)(C)(iii) of section 1395m of this title.

### Amendments

2026—Subsec. (a)(1). Pub. L. 119–75, § 6210(a), substituted “September 30, 2030” for “January 30, 2026”.

Subsec. (a)(3)(E). Pub. L. 119–75, § 6210(b)(1)(B), added concluding provisions.

Subsec. (a)(3)(E)(ii). Pub. L. 119–75, § 6210(b)(1)(A), substituted “the studies described in subsections (b) and (c)” for “the study described in subsection (b)”.

Subsec. (b). Pub. L. 119–75, § 6210(b)(2)(A), substituted “Initial Study” for “Study” in heading.

Subsec. (b)(3). Pub. L. 119–75, § 6210(b)(2)(B), substituted “section” for “subsection”.

Subsecs. (c), (d). Pub. L. 119–75, § 6210(b)(3), (4), added subsec. (c) and redesignated former subsec. (c) as (d). Former subsec. (d) redesignated (e).

Subsec. (e). Pub. L. 119–75, § 6210(b)(3), (5), redesignated subsec. (d) as (e) and substituted “, (b)(1), and (c)(1)” for “and (b)(1)”.

2025—Subsec. (a)(1). Pub. L. 119–37 substituted “January 30, 2026” for “September 30, 2025”.

Pub. L. 119–4 substituted “September 30, 2025” for “March 31, 2025”.

2024—Subsec. (a)(1). Pub. L. 118–158 substituted “March 31, 2025” for “December, 31, 2024”.