Medical Nutrition Therapy Act of 2023

Madam President, I rise today to introduce the Medical Nutrition Therapy Act of 2023, along with my colleague from Michigan, Senator Peters. Our bill would expand Medicare beneficiaries' access to medical nutrition therapy, or MNT, which is a cost-effective component of treatment for obesity, diabetes, hypertension, dyslipidemia, and other chronic conditions.

At a time when the increased prevalence of diet-related chronic conditions is contributing to poor health outcomes and growing healthcare expenditures, 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, it would expand Medicare Part B coverage of outpatient medical nutrition therapy services to a number of 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. This is especially critical for a rural State like Maine, where a NP or PA may be one's trusted primary care provider.

MNT counseling is provided by registered dietician nutritionists, RDNs, as part of a collaborative healthcare team. It is evidenced-based and 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 MNT, individuals benefit from in-depth, individualized nutrition assessments. Follow up visits help reinforce important behavior and lifestyle changes and increase compliance.

Older Americans deserve improved access to this cost-effective medical treatment, but many older adults are missing out under the current Medicare policy. Marcy Kyle, a RDN from Rockport, ME, has seen many patients denied access to medically necessary MNT. One of her patients with prediabetes was referred by his primary care physician for MNT at age 64. At that time, his private insurance covered the service, and he booked the first available appointment the following week. That same week, this patient turned 65 and transitioned onto Medicare. You can imagine his surprise upon arriving for his appointment and learning that MNT would not be covered.

Another unfortunate example from Maine was a patient with a new celiac disease diagnosis complicated by severe weight loss. His private insurance covered MNT as celiac disease is a controllable disease with proper nutrition. But when transitioning from private insurance to Medicare, this patient, too, lost his access to MNT. The saddest situation this RDN has confronted is when an older cancer patient experiences such side effects from cancer treatment as severe weight loss or nausea, which could be prevented with MNT. As with prediabetes and celiac disease, however, Medicare does not cover MNT for cancer patients. This truly is a lost opportunity since we know early treatment with MNT can prevent future and more serious health complications and chronic conditions in older adults. These conditions should be covered.

In addition to leading to confusion and potential delays in care for patients seeking needed healthcare services, we must also consider the staggering economic impact of chronic diseases. According to the U.S. Centers for Disease Control and Prevention, 90 percent of the $3.8 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 one 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.''

MNT can help prevent chronic disease, such as type 2 diabetes. It can better control celiac and other gastrointestinal ailments. It can improve outcomes and the quality of life for those with cancer and other devastating diagnoses. The current Medicare restrictions on medical nutrtition therapy coverage can be detrimental for older adults at a critical juncture in their journey to better health and should be changed.

The Medical Nutrition Therapy Act of 2023 is supported by more than 40 expert national organizations, including 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.

Madam President, I rise today to introduce the Medical Nutrition Therapy Act of 2023, along with my colleague from Michigan, Senator Peters. Our bill would expand Medicare beneficiaries' access to medical nutrition therapy, or MNT, which is a cost-effective component of treatment for obesity, diabetes, hypertension, dyslipidemia, and other chronic conditions.

At a time when the increased prevalence of diet-related chronic conditions is contributing to poor health outcomes and growing healthcare expenditures, 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, it would expand Medicare Part B coverage of outpatient medical nutrition therapy services to a number of 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. This is especially critical for a rural State like Maine, where a NP or PA may be one's trusted primary care provider.

MNT counseling is provided by registered dietician nutritionists, RDNs, as part of a collaborative healthcare team. It is evidenced-based and 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 MNT, individuals benefit from in-depth, individualized nutrition assessments. Follow up visits help reinforce important behavior and lifestyle changes and increase compliance.

Older Americans deserve improved access to this cost-effective medical treatment, but many older adults are missing out under the current Medicare policy. Marcy Kyle, a RDN from Rockport, ME, has seen many patients denied access to medically necessary MNT. One of her patients with prediabetes was referred by his primary care physician for MNT at age 64. At that time, his private insurance covered the service, and he booked the first available appointment the following week. That same week, this patient turned 65 and transitioned onto Medicare. You can imagine his surprise upon arriving for his appointment and learning that MNT would not be covered.

Another unfortunate example from Maine was a patient with a new celiac disease diagnosis complicated by severe weight loss. His private insurance covered MNT as celiac disease is a controllable disease with proper nutrition. But when transitioning from private insurance to Medicare, this patient, too, lost his access to MNT. The saddest situation this RDN has confronted is when an older cancer patient experiences such side effects from cancer treatment as severe weight loss or nausea, which could be prevented with MNT. As with prediabetes and celiac disease, however, Medicare does not cover MNT for cancer patients. This truly is a lost opportunity since we know early treatment with MNT can prevent future and more serious health complications and chronic conditions in older adults. These conditions should be covered.

In addition to leading to confusion and potential delays in care for patients seeking needed healthcare services, we must also consider the staggering economic impact of chronic diseases. According to the U.S. Centers for Disease Control and Prevention, 90 percent of the $3.8 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 one 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.''

MNT can help prevent chronic disease, such as type 2 diabetes. It can better control celiac and other gastrointestinal ailments. It can improve outcomes and the quality of life for those with cancer and other devastating diagnoses. The current Medicare restrictions on medical nutrtition therapy coverage can be detrimental for older adults at a critical juncture in their journey to better health and should be changed.

The Medical Nutrition Therapy Act of 2023 is supported by more than 40 expert national organizations, including 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.