H.R. 5443House116th Congress (2019-2021)In Committee

Isaiah Baker and Margie Harris-Austin Act

AI-Generated Summary

Updated April 14, 2026 at 10:03 AM UTC

The Isaiah Baker and Margie Harris‑Austin Act changes the Medicaid rules in the Social Security Act to make clear that home‑ and community‑based services (HCBS) can be delivered inside an acute‑care hospital. It ensures that patients who receive Medicaid‑funded HCBS can continue those services while hospitalized, as long as they meet certain conditions. The change affects Medicaid recipients, hospitals, and the agencies that oversee HCBS programs.

Key Provisions

Amends Section 1902(h) of the Social Security Act to explicitly include HCBS provided under sections 1915(c), (d), (i), waiver 1115, self‑directed personal assistance services under 1915(j), and attendant services under 1915(k).
Specifies that nothing in titles XIX, XVIII, or XI of the Social Security Act prohibits those HCBS from being provided in an acute‑care hospital when:
• the services are listed in the individual's person‑centered plan of services,
• they address needs not met by standard hospital care,
• they do not replace services the hospital is required to provide, and
• they help ensure a smooth transition from the hospital back to home or community settings.

Legislative Activity

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2 earlier actions

HouseCommittee Latest Action

Referred to the Subcommittee on Health.

Health Subcommittee

December 17, 2019

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HouseIntro Referral

Introduced in House

December 16, 2019

HouseIntro Referral

Referred to the House Committee on Energy and Commerce.

Energy and Commerce Committee

December 16, 2019

HouseCommittee

Referred to the Subcommittee on Health.

Health Subcommittee

December 17, 2019

Bill Text

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Introduced in HouseIssued December 16, 2019

116th CONGRESS

1st Session

H. R. 5443

IN THE HOUSE OF REPRESENTATIVES

December 16, 2019

Ms. Scanlon (for herself and Mr. Emmer) introduced the following bill; which was referred to the Committee on Energy and Commerce

A BILL

To amend title XIX of the Social Security Act to clarify that the provision of home and community-based services is not prohibited in an acute care hospital, and for other purposes.

Short title

This Act may be cited as the Isaiah Baker and Margie Harris-Austin Act.

Providing home and community-based services in acute care hospitals

Section 1902(h) of the Social Security Act (42 U.S.C. 1396a(h)) is amended—

(1)

by inserting (1) after (h);

(2)

by inserting , home and community-based services provided under subsection (c), (d), or (i) of section 1915 or under a waiver under section 1115, self-directed personal assistance services provided pursuant to a written plan of care under section 1915(j), and home and community-based attendant services and supports under section 1915(k) before the period; and

(3)

by adding at the end the following:

(2)

Nothing in this title, title XVIII, or title XI shall be construed as prohibiting receipt of any care or services specified in paragraph (1) in an acute care hospital that are—

(A)

identified in an individual’s person-centered plan of services and supports (or comparable plan of care);

(B)

provided to meet needs of the individual that are not met through the provision of hospital services;

(C)

not a substitute for services that the hospital is obligated to provide through its conditions of participation or under Federal or State law; and

(D)

designed to ensure smooth transitions between acute care settings and home and community-based settings, and to preserve the individual’s functions.