I 
118TH CONGRESS 
1ST SESSION H. R. 6407 
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 
NOVEMBER 14, 2023 
Ms. KELLY of Illinois (for herself and Mrs. KIGGANS of Virginia) 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 com-
mittee 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. 
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 
Therapy Act of 2023’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) Over two-thirds of Medicare fee-for-service 
beneficiaries have 2 or more chronic conditions, 
many of which can be prevented, delayed, treated, or 
managed through nutrition. 
(2) Individuals from many racial and ethnic mi-
nority backgrounds are more likely to be diagnosed 
with chronic diseases such as diabetes, prediabetes, 
chronic kidney disease, end-stage renal disease, and 
obesity. 
(3) Coverage for medical nutrition therapy is 
only available to Medicare Part B beneficiaries with 
diabetes or a renal disease, despite medical nutrition 
therapy being part of the standard of care, in clin-
ical guidelines, and medically necessary for many 
more chronic conditions. 
(4) Medical nutrition therapy has been shown 
to be a cost-effective component of treatment for 
obesity, diabetes, hypertension, dyslipidemia, HIV 
infection, unintended weight loss in older adults, and 
other chronic conditions. 
SEC. 3. EXPANDING THE AVAILABILITY OF MEDICAL NU-
TRITION THERAPY SERVICES UNDER THE 
MEDICARE PROGRAM. 
(a) IN GENERAL.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) is amended— 
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(1) in subsection (s)(2)(V), by striking ‘‘in the 
case of’’ and all that follows through ‘‘organiza-
tions’’; and 
(2) in subsection (vv)— 
(A) in paragraph (1)— 
(i) by striking ‘‘disease management’’ 
and inserting ‘‘the prevention, manage-
ment, or treatment of a disease or condi-
tion specified in paragraph (4)’’; 
(ii) by striking ‘‘by a physician’’ and 
all that follows through the period at the 
end and inserting the following: ‘‘by— 
‘‘(A) a physician (as defined in subsection 
(r)(1)); 
‘‘(B) a physician assistant (as defined in sub-
section (aa)(5)); 
‘‘(C) a nurse practitioner (as defined in sub-
section (aa)(5)); 
‘‘(D) a clinical nurse specialist (as defined in 
subsection (aa)(5)(B)); or 
‘‘(E) in the case of such services furnished to 
manage such a disease or condition that is an eating 
disorder, a clinical psychologist (as defined by the 
Secretary).’’; and 
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(iii) by adding at the end the fol-
lowing new sentence: ‘‘Such term shall not 
include any such services furnished to an 
individual for the prevention, management, 
or treatment of a renal disease if such in-
dividual is receiving maintenance dialysis 
for which payment is made under section 
1881.’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(4) For purposes of paragraph (1), the dis-
eases and conditions specified in this paragraph are 
the following: 
‘‘(A) Diabetes. 
‘‘(B) Prediabetes. 
‘‘(C) A renal disease. 
‘‘(D) Obesity (as defined for purposes of 
subsection (yy)(2)(C) or as otherwise defined by 
the Secretary). 
‘‘(E) Hypertension. 
‘‘(F) Dyslipidemia. 
‘‘(G) Malnutrition. 
‘‘(H) Eating disorders. 
‘‘(I) Cancer. 
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