I 
117TH CONGRESS 
1ST SESSION H. R. 1551 
To amend title XVIII of the Social Security Act to provide coverage of 
medical nutrition therapy services for individuals with eating disorders 
under the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 3, 2021 
Ms. CHU (for herself, Mrs. WALORSKI, Ms. BLUNT ROCHESTER, Ms. MENG, 
Mr. PRICE of North Carolina, Ms. MCCOLLUM, Mrs. NAPOLITANO, Ms. 
SCANLON, Mr. RUSH, Mr. DEUTCH, Mr. VAN DREW, Ms. HOULAHAN, 
Mr. SUOZZI, Mr. MICHAEL F. DOYLE of Pennsylvania, Ms. MATSUI, and 
Mr. FITZPATRICK) 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 committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
coverage of medical nutrition therapy services for individ-
uals with eating disorders 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 ‘‘Nutrition Counseling 
Aiding Recovery for Eating Disorders Act of 2021’’ or the 
‘‘Nutrition CARE Act of 2021’’. 
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SEC. 2. FINDINGS. 
Congress finds the following: 
(1) 28,800,000 individuals in the United Sates, 
or 9 percent of the national population, will have an 
eating disorder in their lifetime. It is estimated that 
1,619,300 to 2,080,600 individuals on Medicare part 
B are affected by an eating disorder, including 
420,500 to 560,700 beneficiaries who identify as 
Black, Indigenous, or People of Color. 
(2) 10,200 deaths per year in the United States 
occur as a direct result of an eating disorder, equat-
ing to 1 death every 52 minutes. Eating disorders 
have one of the highest mortality rates of all mental 
illness due to serious medical comorbidities such as 
stroke, diabetes, and gastric rupture, in addition to 
the fact that longitudinal studies have found that 
the suicide risk for those with an eating disorder is 
23 times the expected risk. 
(3) Eating disorders can be successfully treated 
with care encompassing the 4 pillars of successful 
treatment: medical, psychiatric, therapy, and medical 
nutrition therapy. In general, Medicare provides 
some, but not all, care necessary for eating disorders 
treatment. It doesn’t cover medical nutrition therapy 
at the outpatient level and provides no coverage at 
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the intensive outpatient or residential treatment lev-
els. 
(4) Eating disorders are expensive. The yearly 
economic 
cost 
of 
eating 
disorders 
is 
$64,700,000,000, with families and individuals expe-
riencing an economic loss of $23,500,000,000 per 
year. Each year, eating disorders are directly re-
sponsible for 23,560 inpatient hospitalizations cost-
ing $209,700,000 and 53,918 emergency room visits 
costing $29,300,000. 
(5) Eating disorders in the elderly are particu-
larly serious because chronic disorders or diseases 
may already compromise a patient’s health and 
make a patient more prone to serious comorbidities 
associated with eating disorders, including cardiac, 
metabolic, gastric, and bone conditions. Early diag-
nosis and proper treatment of this population is es-
sential. 
SEC. 3. PROVIDING COVERAGE OF MEDICAL NUTRITION 
THERAPY SERVICES FOR INDIVIDUALS WITH 
EATING DISORDERS UNDER THE MEDICARE 
PROGRAM. 
Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is amended— 
(1) in subsection (s)(2)(V)— 
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(A) by redesignating clauses (i) through 
(iii) as subclauses (I) through (III), respec-
tively, and adjusting the margins accordingly; 
(B) in subclause (III), as so redesignated, 
by striking the semicolon at the end and insert-
ing ‘‘; or’’; 
(C) by striking ‘‘beneficiary with diabetes’’ 
and inserting the following: ‘‘beneficiary— 
‘‘(i) with diabetes’’; and 
(D) by adding at the end the following new 
clause: 
‘‘(ii) beginning January 1, 2022, with an 
eating disorder (as defined by the Secretary in 
accordance with most recent edition of the Di-
agnostic and Statistical Manual of Mental Dis-
orders published by the American Psychiatric 
Association);’’; and 
(2) in subsection (vv)— 
(A) in paragraph (1)— 
(i) by inserting ‘‘(including manage-
ment of an eating disorder (as defined for 
purposes 
of 
subsection 
(s)(2)(V)(ii)))’’ 
after ‘‘disease management’’; 
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