I 
111TH CONGRESS 
1ST SESSION H. R. 3092 
To amend title XIX of the Social Security Act to require States to cover 
medical nutritional therapy as part of Medicaid. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 26, 2009 
Mrs. DAHLKEMPER (for herself, Mr. TIM MURPHY of Pennsylvania, Ms. 
SCHWARTZ, Mrs. HALVORSON, Mr. KENNEDY, Mr. PLATTS, Mrs. CAPPS, 
and Mr. KIND) introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to require 
States to cover medical nutritional therapy as part of 
Medicaid. 
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 ‘‘Obesity Treatment and 
Wellness Act of 2009’’. 
SEC. 2. FINDINGS. 
(a) Congress finds the following: 
(1) The Centers for Disease Control and Pre-
vention (CDC) reports that between 1976 and 1980 
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approximately five percent of youth aged 2–19 were 
obese. In 2006, the rate had increased to 16.3 per-
cent. 
(2) The National Center for Education Statis-
tics report in 2009 finds that almost 1 in 5 Amer-
ican 4-year-olds are obese. 
(3) A New England Journal of Medicine study 
in 1997 found that children who become obese after 
age 6 have a 50 percent greater chance of being 
obese adults. 
(4) The CDC reports that in 2003, approxi-
mately half the costs of treating obesity were paid 
through Medicare or Medicaid. 
(5) The CDC reports that in 2000, the total 
cost of obesity in the United States was estimated 
to be $117 billion. 
(6) To address the obesity epidemic, both pre-
vention and treatment strategies are needed. 
SEC. 3. REQUIRING MEDICAID COVERAGE TO INCLUDE 
COVERAGE OF MEDICAL NUTRITION THER-
APY. 
(a) REQUIREMENT.—Section 1902(a)(10)(A) of the 
Social Security Act (42 U.S.C. 1395a(a)(10)(A)) is 
amended by striking ‘‘and (21)’’ and inserting ‘‘, (21), and 
(28)’’. 
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(b) SERVICES DESCRIBED.—Section 1905 of such 
Act (42 U.S.C. 1396D–(a)) is amended— 
(1) by striking ‘‘and’’ at the end of paragraph 
(27); 
(2) by redesignating paragraph (28) as para-
graph (29); and 
(3) by inserting after paragraph (27) the fol-
lowing new paragraph: 
‘‘(28) medical nutrition therapy (as defined in 
section 1861(vv)(1)) where a physician or primary 
care provider considers it medically necessary to 
treat or prevent the progression of a chronic condi-
tion or disease which the individual is considered as 
having, or at risk of developing, as the result of 
being overweight and obese; and’’. 
(c) EFFECTIVE DATE.— 
(1) Except as provided in paragraph (2), the 
amendments made by subsections (a) and (b) shall 
apply to calendar quarters beginning on or after Oc-
tober 1, 2010, without regard to whether or not 
final regulations to carry out such amendments have 
been promulgated by such date. 
(2) In the case of a State plan for medical as-
sistance under title XIX of the Social Security Act 
which the Secretary of Health and Human Services 
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determines requires State legislation (other than leg-
islation appropriating funds) in order for the plan to 
meet the additional requirements imposed by the 
amendments made by subsections (a) and (b), the 
State plan shall not be regarded as failing to comply 
with the requirements of such title solely on the 
basis of its failure to meet these additional require-
ments before the first day of the first calendar quar-
ter beginning after the close of the first regular ses-
sion 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. 
Æ 
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