HR 6199
Medical Nutrition Therapy Act of 2025
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- Passed House
- Passed Senate
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- Became Law
Bill overview
This bill, the Medical Nutrition Therapy Act of 2025, expands Medicare coverage to include medical nutrition therapy services for a wider range of conditions beyond just diabetes and kidney disease. It allows for referrals from various healthcare professionals, such as physician assistants and clinical psychologists, and covers conditions like obesity, eating disorders, cancer, and HIV/AIDS. The goal is to improve the management and prevention of chronic diseases through nutrition therapy.
Key provisions
- Medicare coverage for medical nutrition therapy is expanded to include conditions beyond diabetes and kidney disease.
- Referrals for medical nutrition therapy can be made by physician assistants, nurse practitioners, clinical nurse specialists, or clinical psychologists (for eating disorders).
- The list of covered conditions includes obesity, eating disorders, cancer, HIV/AIDS, and other chronic illnesses determined by the Secretary.
- Services are now covered for the prevention, management, or treatment of specified diseases and conditions.
- The bill modifies Medicare regulations to align with clinical guidelines and recommendations.
- Services for unintentional weight loss and conditions recommended by the US Preventive Services Task Force are now covered.
- Maintenance dialysis for renal disease is excluded from coverage.
- The effective date for these changes is two years after the bill’s enactment.
Who is affected
- Medicare beneficiaries
Sponsors
Official sponsors from legislative records.
Primary sponsor
Cosponsors
Becca [D-VT-At Large] Balint
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119th CONGRESS — 1st Session
H. R. 6199
IN THE HOUSE OF REPRESENTATIVES
A BILL
To amend title XVIII of the Social Security Act to expand the availability of medical nutrition therapy services under the Medicare program.
This Act may be cited as the Medical Nutrition Therapy Act of 2025
.
Congress finds the following:
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.
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.
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.
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.
Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended—
in subsection (s)(2)(V), by striking in the case of
and all that follows through organizations
; and
in subsection (vv)—
in paragraph (1)—
by striking disease management
and inserting the prevention, management, or treatment of a disease or condition specified in paragraph (4)
;
by striking by a physician
and all that follows through the period at the end and inserting the following:
by—
a physician (as defined in subsection (r)(1));
a physician assistant (as defined in subsection (aa)(5));
a nurse practitioner (as defined in subsection (aa)(5));
a clinical nurse specialist (as defined in subsection (aa)(5)(B)); or
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).
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
by adding at the end the following new paragraph:
For purposes of paragraph (1), the diseases and conditions specified in this paragraph are the following:
Diabetes.
Prediabetes.
A renal disease.
Obesity (as defined for purposes of subsection (yy)(2)(C) or as otherwise defined by the Secretary).
Hypertension.
Dyslipidemia.
Malnutrition.
Eating disorders.
Cancer.
Gastrointestinal diseases, including Celiac disease.
Cardiovascular disease.
Any other disease or condition—
specified by the Secretary relating to unintentional weight loss;
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
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.
Section 1862(a)(1) is amended—
in subparagraph (O), by striking and
at the end;
in subparagraph (P), by striking the semicolon at the end and inserting , and
; and
by adding at the end the following new subparagraph:
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;
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.