Medical Foods and Formulas Access Act of 2025
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
The Medical Foods and Formulas Access Act of 2025 aims to expand access to medically necessary food and related equipment for individuals with digestive or metabolic disorders under Medicare, Medicaid, the Children’s Health Insurance Program, and the Federal Employees Health Benefits Program. The bill defines ‘medically necessary food’ as specially formulated products prescribed by healthcare professionals for specific conditions, and it seeks to ensure that insurance coverage aligns with standard-of-care therapy. It also includes provisions to address formula shortages and reduce reliance on feeding tubes.
Key provisions
- Expands Medicare, Medicaid, CHIP, and FEHBP coverage to include medically necessary food.
- Defines ‘medically necessary food’ as specially formulated products prescribed by healthcare professionals.
- Includes vitamins and amino acids as covered items.
- Requires coverage of medical equipment and supplies necessary to administer medically necessary food.
- Establishes a 80% payment rate for medically necessary food.
- Addresses formula shortages and reduces the use of feeding tubes.
- Expresses Congress’s sense that private health plans should also provide coverage for medically necessary food.
Who is affected
- Individuals with digestive or inherited metabolic disorders
- Families of individuals with digestive or inherited metabolic disorders
- Healthcare practitioners
- Medicare beneficiaries
Bill text
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Sponsors
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16 on record
Primary sponsor
Cosponsors
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