Bill Summary
The Nutrition Counseling Aiding Recovery for Eating Disorders Act of 2019, also known as the Nutrition CARE Act of 2019, is a bill that aims to amend title XVIII of the Social Security Act in order to provide coverage for medical nutrition therapy services for individuals with eating disorders under the Medicare program. The bill states that eating disorders, such as anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding or eating disorders, are severe mental illnesses caused by a complex interaction of genetic, biological, social, behavioral, and psychological factors. It also mentions the high prevalence and mortality rates of eating disorders, particularly among elderly populations. The bill recognizes the importance of early intervention and a comprehensive treatment approach, involving a team of professionals such as social workers, mental health counselors, primary care practitioners, psychiatrists, psychologists, and dietitians. The bill proposes to amend the Social Security Act to include coverage for medical nutrition therapy services for individuals with eating disorders under Medicare. This coverage would be provided by a registered dietitian or nutrition professional, and the services must be referred by a physician or psychologist. The bill also sets specific time limitations for the provision of these services, with at least 13 hours of therapy during the first year of treatment and 4 hours per year thereafter.
Possible Impacts
1. People with Medicare coverage who have eating disorders may now have access to medical nutrition therapy services, which can greatly improve their chances of recovery.
2. Registered dietitians and nutrition professionals may see an increase in demand for their services as they are now able to provide coverage for individuals with eating disorders under Medicare.
3. Families and individuals with eating disorders may experience relief and improved mental and physical health with the comprehensive team approach to treatment, which includes mental health counselors, primary care practitioners, psychiatrists, psychologists, dietitians, and other specialty providers.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 2907 Introduced in Senate (IS)]
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116th CONGRESS
1st Session
S. 2907
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 SENATE OF THE UNITED STATES
November 20, 2019
Ms. Hassan (for herself and Ms. Murkowski) introduced the following
bill; which was read twice and referred to the Committee on Finance
_______________________________________________________________________
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 statues, are affected by eating disorders during
their lifetimes, with disordered eating in elderly persons
showing similar prevalence rates as younger persons.
(3) Eating disorders have one of the highest mortality
rates of all mental illnesses and significant mortality and
morbidity rates associated with elderly populations, 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
appropriate interventions, yet only one-third of persons with
eating disorders receive any 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, and other specialty
providers
(5) 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 ``;
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, 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'';
(ii) by striking ``which are furnished by''
and all that follows through the period and
inserting ``which are furnished--
``(A) by a registered dietitian or nutrition
professional (as defined in paragraph (2));
``(B) pursuant to a referral by--
``(i) a physician (as defined in subsection
(r)(1)) a physician (as defined in subsection
(r)(1)); or
``(ii) a psychologist (or other mental
health professional to the extent authorized
under State law); and
``(C) 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).''; and
(B) by adding at the end the following new
paragraph:
``(4)(A) For purposes of paragraph (1)(C), 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, at least 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) 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.''.
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