An Act To Reduce the Incidence of Obesity and Chronic Disease in the State
Maine Legislature, Session 129, LD 0706
Committee Amendment CA_A_S33 (Senate)
Amends: 22 MRSA §3174-B

COMMITTEE AMENDMENT "ft " to S.P. 219, L.D. 706, Bill, "An Act To 
Reduce the Incidence of Obesity and Chronic Disease in the State" 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 22 MRSA §3174-BBB is enacted to read: 
§3174-BBB. Medical nutrition therapy; rules 
The department shall provide for the reimbursement under the MaineCare program 
for medical nutrition therapy services to treat any medical diagnosis, including, but not 
limited to, obesity, unhealthy weight, hypertension, diabetes, prediabetes, disorders of 
lipid metabolism, HIV infection, unintended weight loss in older adults, chronic kidney 
disease, gastrointestinal conditions, malnutrition and inappropriate eating habits. Medical 
nutrition therapy services may be provided by a physician licensed pursuant to Title 32, 
chapter 36 or 48, a physician assistant licensed pursuant to Title 32, chapter 36 or 48, a 
dietitian licensed pursuant to Title 32, chapter 104 or a nurse practitioner licensed 
pursuant to Title 32, chapter 31 in any office, facility or other setting in which the 
physician, physician assistant, dietitian or nurse practitioner practices. 
As used in this section, "medical nutrition therapy" means a therapeutic approach to 
treating medical conditions and their associated symptoms by use of counseling and a 
specifically tailored diet devised and monitored by a physician licensed pursuant to Title 
32, chapter 36 or 48, a physician assistant licensed pursuant to Title 32, chapter 36 or 48, 
a dietitian licensed pursuant to Title 32, chapter 104 or a nurse practitioner licensed 
pursuant to Title 32, chapter 31. 
The department shall adopt rules to implement this section. Rules adopted pursuant 
to this paragraph are routine technical rules as defined in Title 5, chapter 375, subchapter 
2-A. 
. 
Sec. 2. Appropriations and allocations. 
The following appropriations and 
allocations are made. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ·A "to S.P. 219, L.D. 706 Cs- 6 ~) 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Medical Care - Payments to Providers 0147 
Initiative: Provides appropriations and allocations for reimbursement under the 
MaineCare program for medical nutrition therapy. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
2019-20 
$51,737 
$51,737 
2019-20 
$91,896 
$91,896 
2020-21 
$51,995 
$51,995 
2020-21 
$91,638 
$91,638 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment, which is the unanimous report of the committee, amends the bill by 
changing the term "medical nutritional therapy" to "medical nutrition therapy" to 
accurately reflect common usage of the term. It adds physician assistants to the group of 
medical providers authorized to provide medical nutrition therapy that is reimbursable 
under MaineCare. 
It clarifies that medical nutrition therapy is reimbursable by 
MaineCare in any setting in which the authorized medical provider practices. It also 
removes the provisions of the bill that provide for the reimbursement under the 
MaineCare program for certain prescription drugs to treat obesity. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/21/19 feac 
LD706 
LR 920(02) 
An Act To Reduce the Incidence of Obesity and Chronic Disease in the State 
Fiscal Note for Bill as Amended by Committee Amendment'~" (~-~?:>) 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Federal Expenditures Fund 
Revenue 
Federal Expenditures Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2019-20 
$51,737 
$51,737 
$91,896 
$91,896 
FY 2020-21 
$51,995 
$51,995 
$91,638 
$91,638 
Prajections 
FY2~1~2 
$51,995 
$51,995 
$91,638 
$91,638 
Prajections 
FY2~2~3 
$51,995 
$51,995 
$91,638 
$91,638 
The bill includes General Fund appropriations to the Department of Health and Human Services of $51, 737 in fiscal 
year 2019-20 and $51,995 in fiscal year 2020-21 for reimbursement under the MaineCare program for medical 
nutritional therapy. Federal Expenditures Fund allocations are also included for the FMAP match. 
LR0920(02) - Fiscal Note - Page 1 of 1