I 

118TH CONGRESS 

2D SESSION H. R. 7141 

To amend titles XIX and XXI of the Social Security Act and title XXVII 

of the Public Health Service Act to require no-cost coverage of human 

milk fortifier. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 30, 2024 

Mr. MCGARVEY (for himself, Ms. DELAURO, and Mr. KRISHNAMOORTHI) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend titles XIX and XXI of the Social Security Act 

and title XXVII of the Public Health Service Act to 

require no-cost coverage of human milk fortifier. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Supporting Premature 

5 Infant Nutrition Act of 2024’’. 

6 SEC. 2. REQUIRING NO-COST COVERAGE OF HUMAN MILK 

7 FORTIFIER. 

8 (a) COVERAGE UNDER MEDICAID.— 

9 (1) MANDATORY COVERAGE.— 


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1 (A) IN GENERAL.—Section 1902(a)(10)(A) 

2 of the Social Security Act (42 U.S.C. 

3 1396a(a)(10)(A)) is amended by striking ‘‘and 

4 (30)’’ and inserting ‘‘(30), and (31)’’. 

5 (B) MEDICALLY NEEDY.—Section 

6 1902(a)(10)(C)(iv) of the Social Security Act 

7 (42 U.S.C. 1396a(a)(10)(C)(iv)) is amended by 

8 striking ‘‘and (17)’’ and inserting ‘‘(17), and 

9 (31)’’. 

10 (C) ALTERNATIVE BENEFIT PLANS.—Sec11 tion 1937(b) of the Social Security Act (42 

12 U.S.C. 1396u–7(b)) is amended by adding at 

13 the end the following new paragraph: 

14 ‘‘(9) HUMAN MILK FORTIFIER.—Notwith15 standing the previous provisions of this section, a 

16 State may not provide for medical assistance 

17 through enrollment of an individual with benchmark 

18 coverage or benchmark-equivalent coverage under 

19 this section unless, beginning on January 1, 2025, 

20 such coverage includes (and does not impose any de21 duction, cost sharing, or similar charge for) human 

22 milk fortifier described in section 1905(a)(31).’’. 

23 (2) INCLUSION AS MEDICAL ASSISTANCE.—Sec24 tion 1905 of the Social Security Act (42 U.S.C. 

25 1396d) is amended— 


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1 (A) in subsection (a)— 

2 (i) in paragraph (30), by striking 

3 ‘‘and’’ at the end; 

4 (ii) by redesignating paragraph (31) 

5 as paragraph (32); and 

6 (iii) by inserting after paragraph (30) 

7 the following new paragraph: 

8 ‘‘(31) beginning January 1, 2025, human milk 

9 fortifier (as described in subsection (jj)); and’’; and 

10 (B) by adding at the end the following new 

11 subsection: 

12 ‘‘(jj) HUMAN MILK FORTIFIER.— 

13 ‘‘(1) IN GENERAL.—For purposes of subsection 

14 (a)(31), the term ‘human milk fortifier’ means a 

15 donor human milk-derived product that is furnished 

16 to an infant under 1 year of age if a specified pro17 fessional determines that such donor human milk-de18 rived product is medically necessary for the infant 

19 because— 

20 ‘‘(A) the infant’s gestational age at birth 

21 was 34 weeks or less; 

22 ‘‘(B) the infant— 

23 ‘‘(i) had a birth weight of less than 

24 1800 grams; or 


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1 ‘‘(ii) has a body weight below healthy 

2 levels, as determined by the specified pro3 fessional; or 

4 ‘‘(C) the infant has a congenital or ac5 quired condition and such donor human milk6 derived product will— 

7 ‘‘(i) improve such condition; or 

8 ‘‘(ii) aid in the recovery of the infant 

9 with respect to such condition. 

10 ‘‘(2) DEFINITIONS.—For purposes of this sub11 section, the following definitions apply: 

12 ‘‘(A) DONOR HUMAN MILK-DERIVED PROD13 UCT.—The term ‘donor human milk-derived 

14 product’ means a specialty nutritional product 

15 made from donor human milk wherein the 

16 donor human milk has been concentrated or one 

17 or more components have been removed. 

18 ‘‘(B) SPECIFIED PROFESSIONAL.—The 

19 term ‘specified professional’ means a physician, 

20 nurse practitioner, physician’s assistant, reg21 istered dietician, or other licensed professional 

22 authorized by State statute to make the deter23 mination described in paragraph (1).’’. 

24 (3) PROHIBITION OF COST SHARING.— 


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1 (A) IN GENERAL.—Section 1916 of the So2 cial Security Act (42 U.S.C. 1396o) is amend3 ed— 

4 (i) in subsection (a)(2)— 

5 (I) in subparagraph (I), by strik6 ing at the end ‘‘or’’; 

7 (II) in subparagraph (J), by 

8 striking at the end ‘‘; and’’ and in9 serting ‘‘, or’’; and 

10 (III) by adding at the end the 

11 following new subparagraph: 

12 ‘‘(K) beginning January 1, 2025, human 

13 milk fortifier (as described in section 

14 1905(a)(31)); and’’; and 

15 (ii) in subsection (b)(2)— 

16 (I) in subparagraph (I), by strik17 ing at the end ‘‘or’’; 

18 (II) in subparagraph (J), by 

19 striking at the end ‘‘; and’’ and in20 serting ‘‘, or’’; and 

21 (III) by adding at the end the 

22 following new subparagraph: 

23 ‘‘(K) beginning January 1, 2025, human 

24 milk fortifier (as described in section 

25 1905(a)(31)); and’’. 


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1 (B) APPLICATION TO ALTERNATIVE COST

2 SHARING.—Section 1916A(b)(3)(B) of the So3 cial Security Act (42 U.S.C. 1396o–1(b)(3)(B)) 

4 is amended by adding at the end the following 

5 new clause: 

6 ‘‘(xv) Beginning January 1, 2025, 

7 human milk fortifier (as described in sec8 tion 1905(a)(31)).’’. 

9 (b) COVERAGE UNDER THE CHILDREN’S HEALTH

10 INSURANCE PLAN.— 

11 (1) IN GENERAL.—Section 2103 of the Social 

12 Security Act (42 U.S.C. 1397cc) is amended— 

13 (A) in subsection (a), by striking ‘‘and 

14 (8)’’ and inserting ‘‘, (8), and (13)’’; and 

15 (B) in subsection (c), by adding at the end 

16 the following new paragraph: 

17 ‘‘(13) REQUIRED COVERAGE OF HUMAN MILK

18 FORTIFIER.—The child health assistance provided to 

19 a targeted low-income child shall include coverage of 

20 human milk fortifier (as described in section 

21 1905(a)(31)).’’. 

22 (2) PROHIBITION OF COST SHARING.—Section 

23 2103(e)(2) of the Social Security Act (42 U.S.C. 

24 1397cc(e)(2)) is amended— 


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1 (A) in the paragraph heading, by inserting 

2 ‘‘HUMAN MILK FORTIFIER,’’ before ‘‘OR PREG3 NANCY-RELATED ASSISTANCE’’; and 

4 (B) by inserting ‘‘human milk fortifier de5 scribed in section 1905(a)(31),’’ before ‘‘or for 

6 pregnancy-related assistance’’. 

7 (3) EFFECTIVE DATE.— 

8 (A) IN GENERAL.—Subject to subpara9 graph (B), the amendments made by this sub10 section shall apply with respect to child health 

11 assistance furnished on or after January 1, 

12 2025. 

13 (B) EXCEPTION IF STATE LEGISLATION

14 REQUIRED.—In the case of a State child health 

15 plan for child health assistance under title XXI 

16 of the Social Security Act which the Secretary 

17 of Health and Human Services determines re18 quires State legislation (other than legislation 

19 appropriating funds) in order for the plan to 

20 meet the additional requirement imposed by the 

21 amendments made by this subsection, the State 

22 child health plan shall not be regarded as fail23 ing to comply with the requirements of such 

24 title solely on the basis of its failure to meet 

25 this additional requirement before the first day 


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1 of the first calendar quarter beginning after the 

2 close of the first regular session of the State 

3 legislature that begins after the date of the en4 actment of this Act. For purposes of the pre5 vious sentence, in the case of a State that has 

6 a 2-year legislative session, each year of such 

7 session shall be deemed to be a separate regular 

8 session of the State legislature. 

9 (c) COVERAGE UNDER GROUP HEALTH PLANS AND

10 GROUP AND INDIVIDUAL HEALTH INSURANCE.— 

11 (1) IN GENERAL.—Subpart II of part A of title 

12 XXVII of the Public Health Service Act (42 U.S.C. 

13 300gg–11 et seq.) is amended by adding at the end 

14 the following new section: 

15 ‘‘SEC. 2730. NO-COST COVERAGE OF HUMAN MILK FOR16 TIFIER. 

17 ‘‘A group health plan, and a health insurance issuer 

18 offering group or individual health insurance coverage, 

19 shall provide coverage for, and shall not impose any cost 

20 sharing requirements for, human milk fortifier (as de21 scribed in section 1905(a)(jj) of the Social Security Act).’’. 

22 (2) EFFECTIVE DATE.—The amendments made 

23 by this subsection shall apply to plan years begin24 ning on or after January 1, 2025. 

Æ 


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