[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 1536 Introduced in Senate (IS)]

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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 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 
2021''.

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) The Centers for Disease Control and Prevention finds 
        that individuals are at an increased risk of severe illness 
        from COVID-19 if they have cancer, chronic kidney disease, 
        diabetes, heart conditions such as health failure or coronary 
        artery disease, or obesity.
            (4) 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.
            (5) 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)'';
                            (ii) by inserting ``, physician assistant, 
                        nurse practitioner, clinical nurse specialist 
                        (as such terms are defined in subsection 
                        (aa)(5)), or, in the case of such services 
                        furnished to manage such a disease or condition 
                        that is an eating disorder, clinical 
                        psychologist (as defined by the Secretary)'' 
                        before the period at the end; 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 and prediabetes.
            ``(B) A renal disease.
            ``(C) Obesity (as defined for purposes of subsection 
        (yy)(2)(C) or as otherwise defined by the Secretary).
            ``(D) Hypertension.
            ``(E) Dyslipidemia.
            ``(F) Malnutrition.
            ``(G) Eating disorders.
            ``(H) Cancer.
            ``(I) Gastrointestinal diseases, including Celiac disease.
            ``(J) HIV.
            ``(K) AIDS.
            ``(L) Cardiovascular disease.
            ``(M) 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 with either protocols established 
                by registered dietitians 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 on or after January 
1, 2023.
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