I 

117TH CONGRESS 

1ST SESSION H. R. 3108 

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

of medical nutrition therapy services under the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 11, 2021 

Ms. KELLY of Illinois (for herself and Mr. UPTON) introduced the following 

bill; which was referred to the Committee on Energy and Commerce, and 

in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of 

such provisions as fall within the jurisdiction of the committee concerned 

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 2021’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


kjohnson on DSK79L0C42PROD with BILLS
2 

•HR 3108 IH

1 (1) Over two-thirds of Medicare fee-for-service 

2 beneficiaries have two or more chronic conditions, 

3 many of which can be prevented, delayed, treated, or 

4 managed through nutrition. 

5 (2) Individuals from many racial and ethnic mi6 nority backgrounds are more likely to be diagnosed 

7 with chronic diseases such as diabetes, prediabetes, 

8 chronic kidney disease, end-stage renal disease, and 

9 obesity. 

10 (3) The Centers for Disease Control and Pre11 vention finds that individuals are at an increased 

12 risk of severe illness from COVID–19 if they have 

13 cancer, chronic kidney disease, diabetes, heart condi14 tions such as health failure or coronary artery dis15 ease, or obesity. 

16 (4) Coverage for medical nutrition therapy is 

17 only available to Medicare part B beneficiaries with 

18 diabetes or a renal disease, despite medical nutrition 

19 therapy being part of the standard of care, in clin20 ical guidelines, and medically necessary for many 

21 more chronic conditions. 

22 (5) Medical nutrition therapy has been shown 

23 to be a cost-effective component of treatment for 

24 obesity, diabetes, hypertension, dyslipidemia, HIV 


kjohnson on DSK79L0C42PROD with BILLS
3 

•HR 3108 IH

1 infection, unintended weight loss in older adults and 

2 other chronic conditions. 

3 SEC. 3. EXPANDING THE AVAILABILITY OF MEDICAL NU4 TRITION THERAPY SERVICES UNDER THE 

5 MEDICARE PROGRAM. 

6 (a) IN GENERAL.—Section 1861 of the Social Secu7 rity Act (42 U.S.C. 1395x) is amended— 

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

9 case of’’ and all that follows through ‘‘organiza10 tions’’; and 

11 (2) in subsection (vv)— 

12 (A) in paragraph (1)— 

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

14 and inserting ‘‘the prevention, manage15 ment, or treatment of a disease or condi16 tion specified in paragraph (4)’’; and 

17 (ii) by striking ‘‘by a physician’’ and 

18 all that follows through the period at the 

19 end and inserting the following: ‘‘by a— 

20 ‘‘(A) physician (as defined in subsection 

21 (r)(1)); 

22 ‘‘(B) physician assistant; 

23 ‘‘(C) nurse practitioner; 

24 ‘‘(D) clinical nurse specialist (as defined in 

25 subsection (aa)(5)(B)); or 


kjohnson on DSK79L0C42PROD with BILLS
4 

•HR 3108 IH

1 ‘‘(E) in the case of such services furnished 

2 to manage such a disease or condition that is 

3 an eating disorder, a clinical psychologist (as 

4 defined by the Secretary). 

5 Such term shall not include any services furnished 

6 to an individual for the prevention, management, or 

7 treatment of a renal disease if such individual is re8 ceiving maintenance dialysis for which payment is 

9 made under section 1881.’’; and 

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

11 paragraph: 

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

13 conditions specified in this paragraph are the following: 

14 ‘‘(A) Diabetes and prediabetes. 

15 ‘‘(B) A renal disease. 

16 ‘‘(C) Obesity (as defined for purposes of sub17 section (yy)(2)(C) or as otherwise defined by the 

18 Secretary). 

19 ‘‘(D) Hypertension. 

20 ‘‘(E) Dyslipidemia. 

21 ‘‘(F) Malnutrition. 

22 ‘‘(G) Eating disorders. 

23 ‘‘(H) Cancer. 

24 ‘‘(I) Gastrointestinal diseases, including celiac 

25 disease. 


kjohnson on DSK79L0C42PROD with BILLS
5 

•HR 3108 IH

1 ‘‘(J) HIV. 

2 ‘‘(K) AIDS. 

3 ‘‘(L) Cardiovascular disease. 

4 ‘‘(M) Any other disease or condition— 

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

6 unintentional weight loss; 

7 ‘‘(ii) for which the Secretary determines 

8 the services described in paragraph (1) to be 

9 medically necessary and appropriate for the 

10 prevention, management, or treatment of such 

11 disease or condition, consistent with any appli12 cable recommendations of the United States 

13 Preventive Services Task Force; or 

14 ‘‘(iii) for which the Secretary determines 

15 the services described in paragraph (1) are 

16 medically necessary, consistent with either pro17 tocols established by registered dietitians or nu18 trition professional organizations or with ac19 cepted clinical guidelines identified by the Sec20 retary.’’. 

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

22 is amended— 

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

24 the end; 


kjohnson on DSK79L0C42PROD with BILLS
6 

•HR 3108 IH

1 (2) in subparagraph (P), by striking the semi2 colon at the end and inserting ‘‘, and’’; and 

3 (3) by adding at the end the following new sub4 paragraph: 

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

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

7 not furnished for the prevention, management, or 

8 treatment of a disease or condition specified in para9 graph (4) of such section;’’. 

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

11 this section shall apply with respect to items and services 

12 furnished on or after January 1, 2023. 

Æ 


kjohnson on DSK79L0C42PROD with BILLS