‘‘(29) medically necessary food (as defined in 
subsection (ee)) and food modified to be low protein 
that is formulated to be consumed or administered 
under the supervision of a qualified medical pro-
vider, for the treatment of conditions as rec-
ommended by the Advisory Committee on Heritable 
Disorders in Newborns and Children, and the med-
ical equipment and supplies necessary to administer 
such food; and’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(ee) MEDICALLY NECESSARY FOOD DEFINED.— 
‘‘(1) IN GENERAL.—For purposes of subsection 
(a)(29), the term ‘medically necessary food’— 
‘‘(A) means a food which is formulated to 
be consumed or administered enterally under 
the supervision of a physician and which is in-
tended for the specific dietary management of 
a disease or condition for which distinctive nu-
tritional requirements, based on recognized sci-
entific principles, are established by medical 
evaluation; and 
‘‘(B) includes nutritionally modified coun-
terparts of traditional foods and other forms of 
foods such as formulas, pills, capsules, and 
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bars, so long as consumed or administered 
enterally. 
‘‘(2) ENTERALLY.—For purposes of paragraph 
(1), the term ‘enterally’ refers to consumption or ad-
ministration through the gastrointestinal tract, 
whether orally or by tube.’’. 
(2) EXCEPTION TO REBATE EXCLUSION.—Sec-
tion 1927(d)(2)(E) of the Social Security Act (42 
U.S.C. 1396r–8(d)(2)(E)) is amended by inserting 
‘‘, pharmacological doses of vitamins and amino 
acids used for the treatment of inborn errors of me-
tabolism, for the treatment of conditions as rec-
ommended by the Advisory Committee on Heritable 
Disorders in Newborns and Children and as pre-
scribed by a qualified medical provider,’’ after ‘‘pre-
natal vitamins’’. 
(3) 
CONFORMING
AMENDMENT.—Section 
1902(a)(10)(A) of the Social Security Act (42 
U.S.C. 1396a(a)(10)(A)) is amended, in the matter 
preceding clause (i), by striking ‘‘and (28)’’ and in-
serting ‘‘(28), and (29)’’. 
(4) EXCEPTION TO EFFECTIVE DATE IF STATE 
LEGISLATION REQUIRED.—In the case of a State 
plan for medical assistance under title XIX of the 
Social Security Act which the Secretary of Health 
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and Human Services determines requires State legis-
lation (other than legislation appropriating funds) in 
order for the plan to meet the additional require-
ment imposed by the amendments made by this sub-
section, the State plan shall not be regarded as fail-
ing to comply with the requirements of such title 
solely on the basis of its failure to meet this addi-
tional requirement before the first day of the first 
calendar quarter beginning after the close of the 
first regular session of the State legislature that be-
gins after the date of the enactment of this Act. For 
purposes of the previous sentence, in the case of a 
State that has a 2-year legislative session, each year 
of such session shall be deemed to be a separate reg-
ular session of the State legislature. 
(c) COVERAGE UNDER CHIP.— 
(1) IN GENERAL.— 
(A) MEDICALLY NECESSARY FOOD.—Sec-
tion 2103(c) of the Social Security Act (42 
U.S.C. 1397cc(c)) is amended by adding at the 
end the following: 
‘‘(9) MEDICALLY NECESSARY FOOD.— 
‘‘(A) IN GENERAL.—The child health as-
sistance provided to a targeted low-income child 
under the plan shall include coverage of medi-
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cally necessary food and food modified to be low 
protein that is formulated to be consumed or 
administered under the supervision of a quali-
fied medical provider, for the treatment of con-
ditions as recommended by the Advisory Com-
mittee on Heritable Disorders in Newborns and 
Children, and the medical equipment and sup-
plies necessary to administer such food. 
‘‘(B) DEFINITIONS.—In this paragraph— 
‘‘(i) the term ‘medically necessary 
food’— 
‘‘(I) means a food which is for-
mulated to be consumed or adminis-
tered enterally under the supervision 
of a physician and which is intended 
for the specific dietary management of 
a disease or condition for which dis-
tinctive 
nutritional 
requirements, 
based on recognized scientific prin-
ciples, are established by medical eval-
uation; and 
‘‘(II) includes nutritionally modi-
fied counterparts of traditional foods 
and other forms of foods such as for-
mulas, pills, capsules, and bars, so 
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long as consumed or administered 
enterally; and 
‘‘(ii) the term ‘enterally’ refers to con-
sumption or administration through the 
gastrointestinal tract, whether orally or by 
tube.’’. 
(B) VITAMINS AND AMINO ACIDS.—Section 
2110(a)(6) of the Social Security Act (42 
U.S.C. 1397jj(a)(6)) is amended by striking 
‘‘and biologicals and the administration of such 
drugs and biologicals, only if such drugs and 
biologicals’’ and inserting ‘‘, pharmacological 
doses of vitamins and amino acids used for the 
treatment of inborn errors of metabolism, for 
the treatment of conditions as recommended by 
the Advisory Committee on Heritable Disorders 
in Newborns and Children and as prescribed by 
a qualified medical provider, and biologicals, 
and the administration of such drugs, vitamins 
and amino acids, and biologicals, only if such 
drugs, 
vitamins 
and 
amino 
acids, 
and 
biologicals’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
2103(a) of the Social Security Act (42 U.S.C. 
1397cc(a)) is amended, in the matter preceding 
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