Nutrition Counseling Aiding Recovery for Eating Disorders Act of 2019 or the Nutrition CARE Act of 2019
This bill provides for Medicare coverage of medical nutrition therapy services for individuals with eating disorders. Such services must be furnished by a registered dietitian or nutrition professional pursuant to a referral from a physician, psychologist, or other authorized mental health professional.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3711 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 3711
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
July 11, 2019
Ms. Judy Chu of California (for herself, Mr. Cardenas, Ms. Clarke of
New York, Mr. Fitzpatrick, Mrs. Lee of Nevada, Mr. Raskin, Mr. Rouda,
Mr. Tonko, Ms. Castor of Florida, and Mr. Young) 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 individuals with eating
disorders under the Medicare program.
Be it enacted by the Senate and House of Representatives 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 2019'' or the ``Nutrition CARE Act of
2019''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Eating disorders, including the specific disorders of
anorexia nervosa, bulimia nervosa, binge eating disorder,
avoidant/restrictive food intake disorder, and other specified
feeding or eating disorders, are severe biologically based
mental illnesses caused by a complex interaction of genetic,
biological, social, behavioral, and psychological factors.
(2) Over 30,000,000 individuals in the United States of all
ages, races, sizes, sexual orientations, ethnicities, and
socioeconomic statuses, are affected by eating disorders during
their lifetimes.
(3) Eating disorders have one of the highest mortality
rates of all mental illnesses, as eating disorders can become
fatal due to heart failure, kidney failure, stroke,
hypoglycemia, and gastric rupture. Additionally, longitudinal
studies have found that the suicide risk for those with an
eating disorder is 23 times the expected risk.
(4) Eating disorders can be successfully treated with
interventions at the appropriate durations and levels of care,
yet only one-third of persons with eating disorders receive any
medical, psychiatric, or therapeutic care. Best practice
treatment of eating disorders includes patients, their
families, and a comprehensive team of professionals such as
social workers, mental health counselors, primary care
practitioners, psychiatrists, psychologists, dietitians, art
therapists, and other specialty providers.
(5) Studies examining the prevalence of eating disorders
and insulin restriction among people with diabetes show that up
to 35 percent of women with diabetes restrict insulin in order
to lose weight at some point in their life.
(6) Research shows that disordered eating among older
adults consistently find that rates of disordered eating among
the elderly are similar to those of younger persons.
(7) Weight loss in the elderly may signal an undiagnosed
medical illness or may be the result of a known medical
condition and/or its pharmacologic treatment.
(8) Eating disorders in the elderly are associated with
significant morbidity and mortality, and a wide range of health
issues arise secondary to eating disorders, including cardiac,
metabolic, gastric, and bone conditions; diagnosis and proper
treatment of this population are essential.
(9) Eating disorders in the elderly are particularly
serious because chronic disorders or diseases may already
compromise a patient's health. Inadequate nutrition can result
in memory deficits, cognitive decline, decubitus ulcers,
impaired healing of sores, wounds, or infections, and
dizziness, disorientation, and falls.
(10) Studies find that individuals with chronic illnesses
and/or disabilities are four times more likely to have anorexia
nervosa or bulimia nervosa compared to the general population.
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)--
(A) by redesignating clauses (i) through (iii) as
subclauses (I) through (III), respectively, and
adjusting the margins accordingly;
(B) in subclause (III), as so redesignated, by
striking the semicolon at the end and inserting ``;
and'';
(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, 2020, with an eating
disorder (as defined by the Secretary in accordance
with most recent edition of the Diagnostic and
Statistical Manual of Mental Disorders published by the
American Psychiatric Association);''; and
(2) in subsection (vv)--
(A) in paragraph (1)--
(i) by inserting ``(including management of
an eating disorder (as defined for purposes of
subsection (s)(2)(V)(ii)))'' after ``disease
management''; and
(ii) by inserting ``or psychologist (or
other mental health professional to the extent
authorized under State law) and, in the case of
such services furnished to an individual for
the purpose of management of such an eating
disorder, at the times specified in paragraph
(4)'' before the period at the end; and
(B) by adding at the end the following new
paragraph:
``(4)(A) For purposes of paragraph (1), the times specified in this
paragraph are, with respect to medical nutrition therapy services
furnished to an individual for purposes of management of an eating
disorder, the following:
``(i) 13 hours (including a 1 hour initial assessment and
12 hours of reassessment and intervention) during the 1-year
period beginning on the date such individual is first furnished
such services.
``(ii) Subject to subparagraph (B), 4 hours during each
subsequent 1-year period.
``(B) In the case that the physician or psychologist (or other
mental health professional to the extent authorized under State law)
treating such individual determines that there has been a change with
respect to the diagnosis, medical condition, or treatment regimen
relating to the eating disorder of such individual that requires the
furnishing of medical nutrition therapy services beyond the times
specified in subparagraph (A)(ii), the Secretary may provide for an
additional number of hours to be available to such individual with
respect to a period described in such subparagraph.
``(C) The Secretary may apply such other reasonable limitations
with respect to the furnishing of medical nutrition therapy services
for purposes of management of an eating disorder during a period
described in subparagraph (A)(ii) as the Secretary determines
appropriate.''.
<all>
Introduced in House
Introduced in House
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.
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.
Referred to the Subcommittee on Health.
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