Medical Nutrition Therapy Act of 2021

II 117TH CONGRESS 1ST SESSION S. 1536 To amend title XVIII of the Social Security Act to expand the availability of medical nutrition therapy services under the Medicare program. IN THE SENATE OF THE UNITED STATES MAY 10, 2021 Ms. COLLINS (for herself and Mr. PETERS) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to expand the availability of medical nutrition therapy services under the Medicare program. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Medical Nutrition 4 Therapy Act of 2021’’. 5 SEC. 2. FINDINGS. 6 Congress finds the following: 7 (1) Over two-thirds of Medicare fee-for-service 8 beneficiaries have 2 or more chronic conditions, 9 VerDate Sep 11 2014 21:58 Jun 05, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1536.IS S1536 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 1536 IS many of which can be prevented, delayed, treated, or 1 managed through nutrition. 2 (2) Individuals from many racial and ethnic mi- 3 nority backgrounds are more likely to be diagnosed 4 with chronic diseases such as diabetes, prediabetes, 5 chronic kidney disease, end-stage renal disease, and 6 obesity. 7 (3) The Centers for Disease Control and Pre- 8 vention finds that individuals are at an increased 9 risk of severe illness from COVID–19 if they have 10 cancer, chronic kidney disease, diabetes, heart condi- 11 tions such as health failure or coronary artery dis- 12 ease, or obesity. 13 (4) Coverage for medical nutrition therapy is 14 only available to Medicare Part B beneficiaries with 15 diabetes or a renal disease, despite medical nutrition 16 therapy being part of the standard of care, in clin- 17 ical guidelines, and medically necessary for many 18 more chronic conditions. 19 (5) Medical nutrition therapy has been shown 20 to be a cost-effective component of treatment for 21 obesity, diabetes, hypertension, dyslipidemia, HIV 22 infection, unintended weight loss in older adults, and 23 other chronic conditions. 24 VerDate Sep 11 2014 21:58 Jun 05, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1536.IS S1536 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 1536 IS SEC. 3. EXPANDING THE AVAILABILITY OF MEDICAL NU- 1 TRITION THERAPY SERVICES UNDER THE 2 MEDICARE PROGRAM. 3 (a) IN GENERAL.—Section 1861 of the Social Secu- 4 rity Act (42 U.S.C. 1395x) is amended— 5 (1) in subsection (s)(2)(V), by striking ‘‘in the 6 case of’’ and all that follows through ‘‘organiza- 7 tions’’; and 8 (2) in subsection (vv)— 9 (A) in paragraph (1)— 10 (i) by striking ‘‘disease management’’ 11 and inserting ‘‘the prevention, manage- 12 ment, or treatment of a disease or condi- 13 tion specified in paragraph (4)’’; 14 (ii) by inserting ‘‘, physician assistant, 15 nurse practitioner, clinical nurse specialist 16 (as such terms are defined in subsection 17 (aa)(5)), or, in the case of such services 18 furnished to manage such a disease or con- 19 dition that is an eating disorder, clinical 20 psychologist (as defined by the Secretary)’’ 21 before the period at the end; and 22 (iii) by adding at the end the fol- 23 lowing new sentence: ‘‘Such term shall not 24 include any such services furnished to an 25 individual for the prevention, management, 26 VerDate Sep 11 2014 21:58 Jun 05, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1536.IS S1536 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 1536 IS or treatment of a renal disease if such in- 1 dividual is receiving maintenance dialysis 2 for which payment is made under section 3 1881.’’; and 4 (B) by adding at the end the following new 5 paragraph: 6 ‘‘(4) For purposes of paragraph (1), the diseases and 7 conditions specified in this paragraph are the following: 8 ‘‘(A) Diabetes and prediabetes. 9 ‘‘(B) A renal disease. 10 ‘‘(C) Obesity (as defined for purposes of sub- 11 section (yy)(2)(C) or as otherwise defined by the 12 Secretary). 13 ‘‘(D) Hypertension. 14 ‘‘(E) Dyslipidemia. 15 ‘‘(F) Malnutrition. 16 ‘‘(G) Eating disorders. 17 ‘‘(H) Cancer. 18 ‘‘(I) Gastrointestinal diseases, including Celiac 19 disease. 20 ‘‘(J) HIV. 21 ‘‘(K) AIDS. 22 ‘‘(L) Cardiovascular disease. 23 ‘‘(M) Any other disease or condition— 24 VerDate Sep 11 2014 21:58 Jun 05, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1536.IS S1536 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 1536 IS ‘‘(i) specified by the Secretary relating to 1 unintentional weight loss; 2 ‘‘(ii) for which the Secretary determines 3 the services described in paragraph (1) to be 4 medically necessary and appropriate for the 5 prevention, management, or treatment of such 6 disease or condition, consistent with any appli- 7 cable recommendations of the United States 8 Preventive Services Task Force; or 9 ‘‘(iii) for which the Secretary determines 10 the services described in paragraph (1) are 11 medically necessary, consistent with either pro- 12 tocols established by registered dietitians or nu- 13 trition professional organizations or with ac- 14 cepted clinical guidelines identified by the Sec- 15 retary.’’. 16 (b) EXCLUSION MODIFICATION.—Section 1862(a)(1) 17 is amended— 18 (1) in subparagraph (O), by striking ‘‘and’’ at 19 the end; 20 (2) in subparagraph (P), by striking the semi- 21 colon at the end and inserting ‘‘, and’’; and 22 (3) by adding at the end the following new sub- 23 paragraph: 24 VerDate Sep 11 2014 21:58 Jun 05, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1536.IS S1536 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 1536 IS ‘‘(Q) in the case of medical nutrition therapy 1 services (as defined in section 1861(vv)), which are 2 not furnished for the prevention, management, or 3 treatment of a disease or condition specified in para- 4 graph (4) of such section;’’. 5 (c) EFFECTIVE DATE.—The amendments made by 6 this section shall apply with respect to items and services 7 furnished on or after January 1, 2023. 8 Æ VerDate Sep 11 2014 21:58 Jun 05, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\S1536.IS S1536 pbinns on DSKJLVW7X2PROD with BILLS