I 
116TH CONGRESS 
1ST SESSION H. R. 2501 
To provide for the coverage of medically necessary food and vitamins and 
individual amino acids for digestive and inherited metabolic disorders 
under Federal health programs and private health insurance, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 2, 2019 
Mr. MCGOVERN (for himself, Ms. HERRERA BEUTLER, Mr. FITZPATRICK, and 
Mr. KENNEDY) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees 
on Ways and Means, Armed Services, and Oversight and Reform, 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 com-
mittee concerned 
A BILL 
To provide for the coverage of medically necessary food and 
vitamins and individual amino acids for digestive and 
inherited metabolic disorders under Federal health pro-
grams and private health insurance, and for other pur-
poses. 
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 ‘‘Medical Nutrition Eq-
uity Act of 2019’’. 
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SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Each year, thousands of children and adults 
in the United States are diagnosed with certain di-
gestive or inherited metabolic disorders that prevent 
their bodies from digesting or metabolizing the food 
they need to survive. For them, medically necessary 
food, which can often be administered as an orally 
consumed formula, is their treatment. 
(2) Without medically necessary food, these pa-
tients risk malnutrition, surgery, and repeated hos-
pitalizations. They may suffer intellectual disability 
or even death. Risks in pediatric populations are 
particularly profound and often severe and also in-
clude inadequate growth, abnormal development, 
cognitive impairment, and behavioral disorders. Spe-
cialized medically necessary food is standard-of-care 
therapy for these patients and is essential to pre-
venting such outcomes. 
(3) While not every person diagnosed with these 
conditions needs to be treated with medically nec-
essary food for a prolonged period, it is critical that 
patients and their physicians be able to consider the 
full range of options and select the treatment that 
will be most effective for each patient. 
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(B) EXCEPTION TO EFFECTIVE DATE IF 
STATE LEGISLATION REQUIRED.—In the case of 
a State child health plan for child health assist-
ance under title XXI of the Social Security Act 
which the Secretary of Health and Human 
Services determines requires State legislation 
(other than legislation appropriating funds) in 
order for the plan to meet the additional re-
quirements imposed by the amendments made 
by this subsection, the State child health plan 
shall not be regarded as failing to comply with 
the requirements of such title solely on the 
basis of its failure to meet this additional re-
quirement before the first day of the first cal-
endar quarter beginning after the close of the 
first regular session of the State legislature that 
begins 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 regular session of the 
State legislature. 
(d) MODIFICATION OF DEFINITION OF MEDICALLY 
NECESSARY FOOD AND COVERED DISEASE OR CONDI-
TION UNDER THE TRICARE PROGRAM.— 
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(1) IN GENERAL.—Section 1077(h) of title 10, 
United States Code, is amended— 
(A) in paragraph (2)(A), in the matter 
preceding clause (i), by striking ‘‘or an amino 
acid preparation product’’ and inserting ‘‘, an 
amino acid preparation product, a modified fat 
preparation product, or a nutritional formula 
(including such a formula that does not require 
a prescription)’’; and 
(B) in paragraph (3)— 
(i) in subparagraph (D), by striking 
‘‘and’’ at the end; 
(ii) by redesignating subparagraph 
(E) as subparagraph (F); and 
(iii) by inserting after subparagraph 
(D) the following: 
‘‘(E) Immunoglobulin E or non-Immunoglobulin 
E mediated allergies to food proteins; and’’. 
(2) EFFECTIVE DATE.—The amendments made 
by paragraph (1) shall apply to health care provided 
under chapter 55 of title 10, United States Code, on 
or after the date that is one year after the date of 
the enactment of this Act. 
(e) COVERAGE UNDER FEHBP.— 
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(1) IN
GENERAL.—Section 8902 of title 5, 
United States Code, is amended by adding at the 
end the following: 
‘‘(p) A contract for a plan under this chapter shall 
require the carrier to provide coverage for— 
‘‘(1) medically necessary food (as defined in 
section 1861(kkk) of the Social Security Act) and 
the medical equipment and supplies necessary to ad-
minister such food; and 
‘‘(2) medically necessary vitamins and indi-
vidual amino acids in the same manner provided for 
under section 1860D–2(e)(1)(C) of the Social Secu-
rity Act.’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply with respect to contract 
years beginning on or after the date that is 1 year 
after the date of enactment of this Act. 
(f) COVERAGE UNDER PRIVATE HEALTH INSUR-
ANCE.— 
(1) IN GENERAL.—Subpart II of part A of title 
XXVII of the Public Health Service Act (42 U.S.C. 
300gg–11 et seq.) is amended by adding at the end 
the following: 
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‘‘SEC. 2729A. COVERAGE OF MEDICALLY NECESSARY FOOD, 
VITAMINS, AND INDIVIDUAL AMINO ACIDS. 
‘‘A health insurance issuer offering group or indi-
vidual health insurance coverage shall provide coverage 
for— 
‘‘(1) medically necessary food (as defined in 
section 1861(kkk) of the Social Security Act) and 
the medical equipment and supplies necessary to ad-
minister such food; and 
‘‘(2) medically necessary vitamins and indi-
vidual amino acids in the same manner provided for 
under section 1860D–2(e)(1)(C) of the Social Secu-
rity Act.’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply to plan years beginning 
on or after the date that is 1 year after the date of 
the enactment of this Act. 
(g) NONPREEMPTION OF STATE LAWS THAT PRO-
VIDE GREATER COVERAGE.—Nothing in the provisions of, 
or the amendments made by, this section shall preempt 
a State law that requires coverage of medically necessary 
food and vitamins and individual amino acids for digestive 
and inherited metabolic disorders that exceeds the require-
ments for coverage under such provisions and amend-
ments. 
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(h) MEDICALLY NECESSARY NUTRITION COVERAGE 
INCLUDES COMBINATIONS AND SUPPLIES.—Nothing in 
the provisions of, or the amendments made by, this section 
shall limit coverage of a medically necessary food (as de-
fined in subsection (kkk) of section 1861 of the Social Se-
curity Act, as added by subsection (a)) or the medical 
equipment and supplies necessary to administer such food 
when prescribed, ordered, or recommended in combination 
with another medically necessary food (as so defined) or 
other necessary medical equipment and supplies. 
Æ 
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