I 
119TH CONGRESS 
1ST SESSION H. R. 4569 
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 
JULY 21, 2025 
Mr. MCGARVEY (for himself, Ms. DELAURO, and Mr. KRISHNAMOORTHI) in-
troduced the following bill; which was referred to the Committee on En-
ergy 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Supporting Premature 
Infant Nutrition Act of 2025’’. 
SEC. 2. REQUIRING NO-COST COVERAGE OF HUMAN MILK 
FORTIFIER. 
(a) COVERAGE UNDER MEDICAID.— 
(1) MANDATORY COVERAGE.— 
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(A) IN GENERAL.—Section 1902(a)(10)(A) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396a(a)(10)(A)) is amended by striking ‘‘and 
(30)’’ and inserting ‘‘(30), and (32)’’. 
(B) 
MEDICALLY
NEEDY.—Section 
1902(a)(10)(C)(iv) of the Social Security Act 
(42 U.S.C. 1396a(a)(10)(C)(iv)) is amended by 
striking ‘‘and (17)’’ and inserting ‘‘(17), and 
(32)’’. 
(C) ALTERNATIVE BENEFIT PLANS.—Sec-
tion 1937(b) of the Social Security Act (42 
U.S.C. 1396u–7(b)) is amended by adding at 
the end the following new paragraph: 
‘‘(9) 
HUMAN
MILK
FORTIFIER.—Notwith-
standing the previous provisions of this section, a 
State may not provide for medical assistance 
through enrollment of an individual with benchmark 
coverage or benchmark-equivalent coverage under 
this section unless, beginning on January 1, 2026, 
such coverage includes (and does not impose any de-
duction, cost sharing, or similar charge for) human 
milk fortifier described in section 1905(a)(32).’’. 
(2) INCLUSION AS MEDICAL ASSISTANCE.—Sec-
tion 1905 of the Social Security Act (42 U.S.C. 
1396d) is amended— 
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(A) in subsection (a)— 
(i) in paragraph (31), by striking 
‘‘and’’ at the end; 
(ii) by redesignating paragraph (32) 
as paragraph (33); and 
(iii) by inserting after paragraph (31) 
the following new paragraph: 
‘‘(32) beginning January 1, 2026, human milk 
fortifier (as described in subsection (kk)); and’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(kk) HUMAN MILK FORTIFIER.— 
‘‘(1) IN GENERAL.—For purposes of subsection 
(a)(32), the term ‘human milk fortifier’ means a 
donor human milk-derived product that is furnished 
to an infant under 1 year of age if a specified pro-
fessional determines that such donor human milk-de-
rived product is medically necessary for the infant 
because— 
‘‘(A) the infant’s gestational age at birth 
was 34 weeks or less; 
‘‘(B) the infant— 
‘‘(i) had a birth weight of less than 
1800 grams; or 
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‘‘(ii) has a body weight below healthy 
levels, as determined by the specified pro-
fessional; or 
‘‘(C) the infant has a congenital or ac-
quired condition and such donor human milk- 
derived product will— 
‘‘(i) improve such condition; or 
‘‘(ii) aid in the recovery of the infant 
with respect to such condition. 
‘‘(2) DEFINITIONS.—For purposes of this sub-
section, the following definitions apply: 
‘‘(A) DONOR HUMAN MILK-DERIVED PROD-
UCT.—The term ‘donor human milk-derived 
product’ means a specialty nutritional product 
made from donor human milk wherein the 
donor human milk has been concentrated or one 
or more components have been removed. 
‘‘(B) 
SPECIFIED
PROFESSIONAL.—The 
term ‘specified professional’ means a physician, 
nurse practitioner, physician’s assistant, reg-
istered dietician, or other licensed professional 
authorized by State statute to make the deter-
mination described in paragraph (1).’’. 
(3) PROHIBITION OF COST SHARING.— 
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(A) IN GENERAL.—Section 1916 of the So-
cial Security Act (42 U.S.C. 1396o) is amend-
ed— 
(i) in subsection (a)(2)— 
(I) in subparagraph (I), by strik-
ing at the end ‘‘or’’; 
(II) in subparagraph (J), by 
striking at the end ‘‘; and’’ and in-
serting ‘‘, or’’; and 
(III) by adding at the end the 
following new subparagraph: 
‘‘(K) beginning January 1, 2026, human 
milk 
fortifier 
(as 
described 
in 
section 
1905(a)(32)); and’’; and 
(ii) in subsection (b)(2)— 
(I) in subparagraph (I), by strik-
ing at the end ‘‘or’’; 
(II) in subparagraph (J), by 
striking at the end ‘‘; and’’ and in-
serting ‘‘, or’’; and 
(III) by adding at the end the 
following new subparagraph: 
‘‘(K) beginning January 1, 2026, human 
milk 
fortifier 
(as 
described 
in 
section 
1905(a)(32)); and’’. 
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