[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 2907 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                S. 2907

To amend title XVIII of the Social Security Act to provide coverage of 
    medical nutrition therapy services for individuals with eating 
                 disorders under the Medicare program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           November 20, 2019

  Ms. Hassan (for herself and Ms. Murkowski) 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 provide coverage of 
    medical nutrition therapy services for individuals with eating 
                 disorders 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 ``Nutrition Counseling Aiding Recovery 
for Eating Disorders Act of 2019'' or the ``Nutrition CARE Act of 
2019''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Eating disorders, including the specific disorders of 
        anorexia nervosa, bulimia nervosa, binge eating disorder, 
        avoidant/restrictive food intake disorder, and other specified 
        feeding or eating disorders, are severe biologically based 
        mental illnesses caused by a complex interaction of genetic, 
        biological, social, behavioral, and psychological factors.
            (2) Over 30,000,000 individuals in the United States of all 
        ages, races, sizes, sexual orientations, ethnicities, and 
        socioeconomic statues, are affected by eating disorders during 
        their lifetimes, with disordered eating in elderly persons 
        showing similar prevalence rates as younger persons.
            (3) Eating disorders have one of the highest mortality 
        rates of all mental illnesses and significant mortality and 
        morbidity rates associated with elderly populations, as eating 
        disorders can become fatal due to heart failure, kidney 
        failure, stroke, hypoglycemia, and gastric rupture. 
        Additionally, longitudinal studies have found that the suicide 
        risk for those with an eating disorder is 23 times the expected 
        risk.
            (4) Eating disorders can be successfully treated with 
        appropriate interventions, yet only one-third of persons with 
        eating disorders receive any care. Best practice treatment of 
        eating disorders includes patients, their families, and a 
        comprehensive team of professionals such as social workers, 
        mental health counselors, primary care practitioners, 
        psychiatrists, psychologists, dietitians, and other specialty 
        providers
            (5) Studies find that individuals with chronic illnesses 
        and/or disabilities are four times more likely to have anorexia 
        nervosa or bulimia nervosa compared to the general population.

SEC. 3. PROVIDING COVERAGE OF MEDICAL NUTRITION THERAPY SERVICES FOR 
              INDIVIDUALS WITH EATING DISORDERS UNDER THE MEDICARE 
              PROGRAM.

    Section 1861 of the Social Security Act (42 U.S.C. 1395x) is 
amended--
            (1) in subsection (s)(2)(V)--
                    (A) by redesignating clauses (i) through (iii) as 
                subclauses (I) through (III), respectively, and 
                adjusting the margins accordingly;
                    (B) in subclause (III), as so redesignated, by 
                striking the semicolon at the end and inserting ``; 
                or'';
                    (C) by striking ``beneficiary with diabetes'' and 
                inserting the following: ``beneficiary--
                    ``(i) with diabetes''; and
                    (D) by adding at the end the following new clause:
                    ``(ii) beginning January 1, 2020, with an eating 
                disorder (as defined by the Secretary in accordance 
                with most recent edition of the Diagnostic and 
                Statistical Manual of Mental Disorders published by the 
                American Psychiatric Association);''; and
            (2) in subsection (vv)--
                    (A) in paragraph (1)--
                            (i) by inserting ``(including management of 
                        an eating disorder (as defined for purposes of 
                        subsection (s)(2)(V)(ii))))'' after ``disease 
                        management'';
                            (ii) by striking ``which are furnished by'' 
                        and all that follows through the period and 
                        inserting ``which are furnished--
                    ``(A) by a registered dietitian or nutrition 
                professional (as defined in paragraph (2));
                    ``(B) pursuant to a referral by--
                            ``(i) a physician (as defined in subsection 
                        (r)(1)) a physician (as defined in subsection 
                        (r)(1)); or
                            ``(ii) a psychologist (or other mental 
                        health professional to the extent authorized 
                        under State law); and
                    ``(C) in the case of such services furnished to an 
                individual for the purpose of management of such an 
                eating disorder, at the times specified in paragraph 
                (4).''; and
                    (B) by adding at the end the following new 
                paragraph:
    ``(4)(A) For purposes of paragraph (1)(C), the times specified in 
this paragraph are, with respect to medical nutrition therapy services 
furnished to an individual for purposes of management of an eating 
disorder, at least the following:
            ``(i) 13 hours (including a 1-hour initial assessment and 
        12 hours of reassessment and intervention) during the 1-year 
        period beginning on the date such individual is first furnished 
        such services.
            ``(ii) Subject to subparagraph (B), 4 hours during each 
        subsequent 1-year period.
    ``(B) The Secretary may apply such other reasonable limitations 
with respect to the furnishing of medical nutrition therapy services 
for purposes of management of an eating disorder during a period 
described in subparagraph (A)(ii) as the Secretary determines 
appropriate.''.
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