[Congressional Record Volume 172, Number 38 (Thursday, February 26, 2026)]
[Senate]
[Page S709]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Mr. Peters):
  S. 3934. A bill to amend title XVIII of the Social Security Act to 
expand the availability of medical nutrition therapy services under the 
Medicare program; to the Committee on Finance.
  Ms. COLLINS. Mr. President, I rise today to introduce the Medical 
Nutrition Therapy Act of 2026, along with my colleague from Michigan 
Senator Peters. Our bill will expand Medicare beneficiaries' access to 
medical nutrition therapy, or MNT, which is a cost-effective component 
of treatment for obesity, diabetes, hypertension, and other chronic 
conditions. Increasing access to MNT should be part of the strategy to 
improve disease management and prevention for America's seniors. The 
Medical Nutrition Therapy Act would make two important changes to 
support patients, improve health outcomes, and reduce unnecessary 
healthcare costs.
  First, the bill would expand Medicare Part B coverage of outpatient 
medical nutrition therapy services to several currently uncovered 
diseases or conditions, including prediabetes, obesity, high blood 
pressure, high cholesterol, malnutrition, eating disorders, cancer, 
HIV/AIDS, gastrointestinal diseases including celiac disease, and 
cardiovascular disease. Currently, Medicare Part B only covers 
outpatient MNT for diabetes, renal disease, and post-kidney transplant.
  Second, the bill would allow more types of providers--including nurse 
practitioners, physician assistants, clinical nurse specialists, and 
psychologists--to refer patients to MNT. Right now, only physicians may 
refer patients to dieticians for medical nutrition therapy. Expanding 
the types of providers who make these referrals would be especially 
significant for patients in a rural State like Maine where an NP or PA 
may be one's trusted primary care provider.
  MNT counseling is provided by registered dietitian nutritionists, 
RDNs, as part of a collaborative healthcare team. It is evidence-based 
and has been proven to positively affect weight, blood pressure, blood 
lipids, and blood sugar control. Nutritional counseling by RDNs is 
recommended by the National Lipid Association to promote long-term 
adherence to an individualized, heart-healthy diet. Through MST, 
individuals benefit from in-depth, individualized nutrition 
assessments. Followup visits help reinforce important behavior and 
lifestyle changes and increase compliance.
  Seniors deserve improved access to this cost-effective medical 
treatment, but many older adults are missing out under the current 
Medicare policy. I heard from a dietitian in rural Washington County, 
ME, who is the only part-time dietitian in the county and works at a 
federally qualified health center, FQHC. One of her patients is an 
elderly man with severe tooth decay requiring a modified personalized 
meal plan. He lost 40 pounds in 1 year despite being cleared for any 
gastrointestinal or other underlying medical condition that could have 
caused this extreme weight loss. He became clinically malnourished. 
Finally, his primary care provider referred him to the dietitian at the 
FQHC for medical nutrition therapy with a diagnosis of failure to 
thrive.
  Because this patient, however, did not have a diagnosis of diabetes 
or renal disease, the FQHC at which he received treatment will not 
receive Medicare reimbursement for the three 60-minute medical 
nutrition therapy sessions that the dietitian provided. At his third 
and final session, the patient shared that this dietitian was the most 
helpful provider with whom he had ever met. He is no longer afraid of 
eating and has more good days enjoying meals with family and friends.
  Another patient from Maine, who is a Medicare beneficiary, was 
treated for severe obesity with gastric bypass surgery. This patient 
was unable to afford out of pocket costs to receive post-operative 
medical nutrition therapy. He struggled with post-operative diet 
advancement, which led to hospitalization for severe dehydration and 
failure to thrive within the first 3 months after surgery. One year 
after surgery, this patient had severe nutritional anemia requiring 
iron infusion and monthly vitamin B-12 injections. This tragic 
situation could have been prevented if the MNT he needed had been 
covered by Medicare. Early treatment with MNT can prevent serious 
health complications and chronic conditions, particularly in older 
adults.
  In addition to the human cost, there is a financial one: the impact 
on the Medicare Program. This should not come as a surprise since the 
health and economic effects of chronic diseases are staggering. 
According to the U.S. Centers for Disease Control and Prevention, 90 
percent of the $4.9 trillion that the United States spends annually on 
healthcare goes to the treatment of people with chronic diseases and 
mental health conditions. Preventing chronic diseases, or managing 
symptoms when prevention is not possible is an effective way to reduce 
these costs. This is particularly important for the Medicare Program as 
more than two-thirds of seniors on Medicare live with multiple chronic 
conditions. As one registered dietitian nutritionist in Maine told me, 
``We all know a dollar spent on prevention saves many health care 
dollars in the long run and is the right thing to do for our seniors at 
a time when they have limited budgets.''
  The Medical Nutrition Therapy Act of 2025 is supported by the Academy 
of Nutrition and Dietetics, the American Diabetes Association, the 
Endocrine Society, and UsAgainstAlzheimer's. I urge my colleagues to 
support this important legislation to improve access to cost-effective 
medical treatment for Medicare patients with chronic diseases.

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