Medical Foods and Formulas Access Act of 2025
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Overview
The Medical Foods and Formulas Access Act of 2025 aims to expand health coverage under Medicare, Medicaid, the Children’s Health Insurance Program, and the Federal Employees Health Benefits Program to include medically necessary food and associated equipment. The bill defines ‘medically necessary food’ as specially formulated products prescribed by healthcare professionals for individuals with specific digestive or metabolic disorders. It also seeks to ensure that insurance coverage for these foods doesn’t unnecessarily require feeding tubes and promotes access to vitamins and amino acids for patients with related conditions.
Key provisions
- Expands Medicare, Medicaid, CHIP, and FEHBP to cover medically necessary food.
- Defines ‘medically necessary food’ as specially formulated products prescribed by healthcare professionals.
- Prohibits requiring medically necessary food to be administered through feeding tubes unless medically indicated.
- Includes vitamins and amino acids in covered items.
- Applies to individuals with inherited metabolic disorders, malabsorption conditions, and certain food allergies.
- Establishes an 80% payment rate for medically necessary food under Medicare.
- Requires coverage of medically necessary food under Medicaid and CHIP.
- Encourages private health plans to provide similar coverage.
Who is affected
- Individuals with digestive or inherited metabolic disorders
- Families of affected children
Bill text
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Sponsors
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7 on record
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