[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6407 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 6407

     To amend title XVIII of the Social Security Act to expand the 
 availability of medical nutrition therapy services under the Medicare 
                                program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 14, 2023

   Ms. Kelly of Illinois (for herself and Mrs. Kiggans of Virginia) 
 introduced the following bill; which was referred to the Committee on 
   Energy and Commerce, and in addition to the Committee on Ways and 
 Means, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 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)'';
                            (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));
            ``(C) a nurse practitioner (as defined in subsection 
        (aa)(5));
            ``(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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