II 

116TH CONGRESS 

2D SESSION S. 4504 

To amend title XVIII of the Social Security Act to expand the availability 

of medical nutrition therapy services under the Medicare program. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 6, 2020 

Ms. COLLINS (for herself and Mr. PETERS) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to expand 

the availability of medical nutrition therapy services 

under the Medicare program. 

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 ‘‘Medical Nutrition 

5 Therapy Act of 2020’’. 

6 SEC. 2. EXPANDING THE AVAILABILITY OF MEDICAL NU7 TRITION THERAPY SERVICES UNDER THE 

8 MEDICARE PROGRAM. 

9 (a) IN GENERAL.—Section 1861 of the Social Secu10 rity Act (42 U.S.C. 1395x) is amended— 


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1 (1) in subsection (s)(2)(V), by striking ‘‘in the 

2 case of’’ and all that follows through ‘‘organiza3 tions’’; and 

4 (2) in subsection (vv)— 

5 (A) in paragraph (1)— 

6 (i) by striking ‘‘disease management’’ 

7 and inserting ‘‘the prevention, manage8 ment, or treatment of a disease or condi9 tion specified in paragraph (4)’’; 

10 (ii) by inserting ‘‘or by a physician as11 sistant, nurse practitioner, or clinical nurse 

12 specialist (as such terms are defined in 

13 subsection (aa)(5)), or, in the case of such 

14 services furnished to manage such a dis15 ease or condition that is an eating dis16 order, by a clinical psychologist (as defined 

17 by the Secretary)’’ before the period at the 

18 end; and 

19 (iii) by adding at the end the fol20 lowing new sentence: ‘‘Such term shall not 

21 include any such services furnished to an 

22 individual for the prevention, management, 

23 or treatment of a renal disease if such in24 dividual is receiving maintenance dialysis 


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1 for which payment is made under section 

2 1881.’’; and 

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

4 paragraph: 

5 ‘‘(4) For purposes of paragraph (1), the diseases and 

6 conditions specified in this paragraph are the following: 

7 ‘‘(A) Diabetes and prediabetes. 

8 ‘‘(B) A renal disease. 

9 ‘‘(C) Obesity (as defined for purposes of sub10 section (yy)(2)(C) or as otherwise defined by the 

11 Secretary). 

12 ‘‘(D) Hypertension. 

13 ‘‘(E) Dyslipidemia. 

14 ‘‘(F) Malnutrition. 

15 ‘‘(G) Eating disorders. 

16 ‘‘(H) Cancer. 

17 ‘‘(I) Celiac disease. 

18 ‘‘(J) HIV. 

19 ‘‘(K) AIDS. 

20 ‘‘(L) Any other disease or condition— 

21 ‘‘(i) specified by the Secretary relating to 

22 unintentional weight loss; 

23 ‘‘(ii) for which the Secretary determines 

24 the services described in paragraph (1) to be 

25 medically necessary and appropriate for the 


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1 prevention, management, or treatment of such 

2 disease or condition, consistent with any appli3 cable recommendations of the United States 

4 Preventive Services Task Force; or 

5 ‘‘(iii) for which the Secretary determines 

6 the services described in paragraph (1) are 

7 medically necessary, consistent with either pro8 tocols established by registered dietitians or nu9 trition professional organizations or with ac10 cepted clinical guidelines identified by the Sec11 retary.’’. 

12 (b) EXCLUSION MODIFICATION.—Section 1862(a)(1) 

13 is amended— 

14 (1) in subparagraph (O), by striking ‘‘and’’ at 

15 the end; 

16 (2) in subparagraph (P), by striking the semi17 colon at the end and inserting ‘‘, and’’; and 

18 (3) by adding at the end the following new sub19 paragraph: 

20 ‘‘(Q) in the case of medical nutrition therapy 

21 services (as defined in section 1861(vv)), which are 

22 not furnished for the prevention, management, or 

23 treatment of a disease or condition specified in para24 graph (4) of such section;’’. 


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1 (c) EFFECTIVE DATE.—The amendments made by 

2 this section shall apply with respect to items and services 

3 furnished on or after January 1, 2021. 

Æ 


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