[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3297 Introduced in Senate (IS)]
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118th CONGRESS
1st Session
S. 3297
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
November 14 (legislative day, November 13), 2023
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 Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medical Nutrition Therapy Act of
2023''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Over two-thirds of Medicare fee-for-service
beneficiaries have 2 or more chronic conditions, many of which
can be prevented, delayed, treated, or managed through
nutrition.
(2) Individuals from many racial and ethnic minority
backgrounds are more likely to be diagnosed with chronic
diseases such as diabetes, prediabetes, chronic kidney disease,
end-stage renal disease, and obesity.
(3) Coverage for medical nutrition therapy is only
available to Medicare Part B beneficiaries with diabetes or a
renal disease, despite medical nutrition therapy being part of
the standard of care, in clinical guidelines, and medically
necessary for many more chronic conditions.
(4) Medical nutrition therapy has been shown to be a cost-
effective component of treatment for obesity, diabetes,
hypertension, dyslipidemia, HIV infection, unintended weight
loss in older adults, and other chronic conditions.
SEC. 3. EXPANDING THE AVAILABILITY OF MEDICAL NUTRITION THERAPY
SERVICES UNDER THE MEDICARE PROGRAM.
(a) In General.--Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended--
(1) in subsection (s)(2)(V), by striking ``in the case of''
and all that follows through ``organizations''; and
(2) in subsection (vv)--
(A) in paragraph (1)--
(i) by striking ``disease management'' and
inserting ``the prevention, management, or
treatment of a disease or condition specified
in paragraph (4)''; and
(ii) by striking ``by a physician'' and all
that follows through the period at the end and
inserting the following: ``by--
``(A) a physician (as defined in subsection
(r)(1));
``(B) a physician assistant (as defined in
subsection (aa)(5)(A));
``(C) a nurse practitioner (as defined in
subsection (aa)(5)(A));
``(D) a clinical nurse specialist (as defined in
subsection (aa)(5)(B)); or
``(E) in the case of such services furnished to
manage such a disease or condition that is an eating
disorder, a clinical psychologist (as defined by the
Secretary).''; and
(iii) by adding at the end the following
new sentence: ``Such term shall not include any
such services furnished to an individual for
the prevention, management, or treatment of a
renal disease if such individual is receiving
maintenance dialysis for which payment is made
under section 1881.''; and
(B) by adding at the end the following new
paragraph:
``(4) For purposes of paragraph (1), the diseases and conditions
specified in this paragraph are the following:
``(A) Diabetes.
``(B) Prediabetes.
``(C) A renal disease.
``(D) Obesity (as defined for purposes of subsection
(yy)(2)(C) or as otherwise defined by the Secretary).
``(E) Hypertension.
``(F) Dyslipidemia.
``(G) Malnutrition.
``(H) Eating disorders.
``(I) Cancer.
``(J) Gastrointestinal diseases, including Celiac disease.
``(K) HIV.
``(L) AIDS.
``(M) Cardiovascular disease.
``(N) Any other disease or condition--
``(i) specified by the Secretary relating to
unintentional weight loss;
``(ii) for which the Secretary determines the
services described in paragraph (1) to be medically
necessary and appropriate for the prevention,
management, or treatment of such disease or condition,
consistent with any applicable recommendations of the
United States Preventive Services Task Force; or
``(iii) for which the Secretary determines the
services described in paragraph (1) are medically
necessary, consistent either with protocols established
by registered dietitian or nutrition professional
organizations or with accepted clinical guidelines
identified by the Secretary.''.
(b) Exclusion Modification.--Section 1862(a)(1) is amended--
(1) in subparagraph (O), by striking ``and'' at the end;
(2) in subparagraph (P), by striking the semicolon at the
end and inserting ``, and''; and
(3) by adding at the end the following new subparagraph:
``(Q) in the case of medical nutrition therapy services (as
defined in section 1861(vv)), which are not furnished for the
prevention, management, or treatment of a disease or condition
specified in paragraph (4) of such section;''.
(c) Effective Date.--The amendments made by this section shall
apply with respect to items and services furnished in years beginning
on or after the date that is 2 years after the date of the enactment of
this Act.
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