[Congressional Record Volume 142, Number 105 (Wednesday, July 17, 1996)]
[Senate]
[Page S8015]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BINGAMAN (for himself and Mr. Hollings):
  S. 1964. A bill to amend title XVIII of the Social Security Act to 
provide for coverage under part B of the Medicare Program of medical 
nutrition therapy services of registered dietitians and nutrition 
professionals; to the Committee on Finance.


               The Medical Nutrition Therapy Act of 1996

 Mr. BINGAMAN. Mr. President, I introduce the Medical Nutrition 
Therapy Act of 1996 on behalf of myself and my friend and colleague 
from South Carolina, Senator Hollings.
  This legislation is similar to a bill, H.R. 2247, that was introduced 
last year in the House by Representative Jose Serrano. It provides for 
coverage under part B of the Medicare Program of medical nutrition 
therapy services which are furnished by or under the supervision of a 
registered dietitian or nutrition professional.
  Mr. President, at a time when the Medicare system is under increasing 
scrutiny and the Congress and administration are debating how to ensure 
the long-term stability of the program, I believe that the legislation 
I am introducing should be an integral part of those debates.
  Medical nutrition therapy is the assessment of patient nutritional 
status followed by therapy, ranging from diet modification to 
administration of specialized nutrition therapies such as intravenous 
or tube feedings. It has proven to be a medically necessary and cost-
effective way of treating and controlling many diseases and medical 
conditions, including AIDS, cancer, kidney disease, diabetes, and 
severe burns. The treatment of all of these conditions and numerous 
others saves health care costs by speeding recovery and reducing the 
incidence of complications. This in turn results in fewer 
hospitalizations, shorter hospital stays, and reduced drug, surgery, 
and treatment needs.
  An analysis of nearly 2,400 case studies submitted by members of 
American Dietetic Association members showed that on average more than 
$8,000 per patient can be saved with the intervention of medical 
nutrition therapy. The July 1995 issue of the American Journal of 
Medicine highlighted a study that found that the use of a diabetes 
team, led by an endocrinologist working with a nurse diabetes educator 
and dietitian, resulted in a 56-percent reduction in length of hospital 
stays among patients hospitalized with a primary diagnosis of diabetes 
compared with patients treated by an internist alone. Currently, 
hospital care of diabetic patients costs an estimated $65 billion a 
year. The potential 5-day reduction in hospitalization found by this 
study translates into billions of dollars per year in potential health 
care savings and that is only the savings related to diabetes 
treatment. The true saving resulting from the increased use of medical 
nutrition therapy in other illnesses is substantial and that is why I 
am here today to offer this legislation.
  Mr. President, no consistent policy or approach exists for covering 
the costs for medical nutrition therapy. In inpatient settings, 
dietitians' services are often folded into hospital room and board 
charges and are not reimbursed while equipment and prescribed medical 
nutritional products are often, but not always, treated in the same 
manner. In outpatient settings, coverage is inconsistent for both 
dietitians' services and other nutrition therapies. Medicare and some 
Medicaid programs cover physician-prescribed medical nutrition 
therapies as part of a home care therapy benefit. However, professional 
dietitian services are not covered as a reimbursable expense.
  I believe that we need to change this and the legislation I am 
offering today will achieve that. I also believe that as the relevant 
studies are developed it will be clearly shown that coverage of medical 
nutrition therapy of reducing health care expenditures and should be an 
integral part of any long-term solution to the solvency of the Medicare 
Program.
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