,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #cffe  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #e1 #bjac,mr4
 ,delaney 7= himself1 ,mr4 ,goodlatte1  
,mr4 ,polis1 ,mr4 ,johnson ( ,georgia1 &
 ,ms4 ,moore7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committees
 on ,ways & ,means1 ,arm$ ,s]vices1 &   
,ov]sight & ,gov]nm5t ,re=m1 = a p]iod  
to be subsequ5tly det]m9$ by ! ,speak]1 
9 ea* case = consid]ation ( su*         
provisions z fall )9 ! jurisdiction ( ! 
committee conc]n$  ,a ,,bill  ,to       
provide = ! cov]age ( m$ically necess>y 
food "u ,f$]al heal? programs1 & = o!r  
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,m$ical ,foods ,equity ,act
 ( #bjac4  #b4 ,f9d+s ,congress f9ds !  
foll[+3 7#a7 ,newborns are scre5$ =     
inborn errors ( metabolism1 b treatm5t =
 su* conditions is n uni=mly cov]$ by   
insurance4  7#b7 ,ea* ye> approximately 
#b1eej *ildr5 9 ! ,unit$ ,/ates are     
diagnos$ ) an inborn error ( metabolism 

disord]1 requir+ foods modifi$ to be    
void ( ! nutri5t or nutri5ts ! *ild's   
body is incapable ( process+1 or requir+
 supplem5tation ) vitam9s or am9o acids4
  7#c7 ,m ?an #ce ,/ates h pass$ laws to
 at lea/ p>tially address ! inequity 9  
cov]age = m$ically necess>y foods1      
critical treatm5t = su* disord]s4  7#d7 
,! co/ associat$ ) provid+ m$ically     
necess>y foods pres5ts a l>ge f9ancial  
burd5 = _m families4  7#e7 ,!re is no   
curr5t cure = inborn errors ( metabolism
 disord]s & treatm5t is necess>y dur+ ! 
entire lifespan ( ! individual4  #c4    
,cov]age 9 c]ta9 ,f$]al heal? programs (
 m$ically necess>y food & food modifi$  
to be l[ prote9  7a7 ,cov]age "u !      
,m$ic>e program  7#a7 ,cov]age (        
m$ically necess>y food "u ! orig9al     
m$ic>e fee-=-s]vice program  7,a7 ,9    
g5]al ,section #ahfa7s77#b7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciex7s77#b77 is am5d$-- 7i7 9         
subp>agraph 7,,ee71 by /rik+ & at ! end2
  7ii7 9 subp>agraph 7,,ff71 by ins]t+ &

 at ! end2 &  7iii7 by add+ at ! end !  
foll[+ new subp>agraph3  7,,gg7 m$ically
 necess>y food 7z def9$ 9 subsection    
7iii77 & food modifi$ to be l[ prote9 t 
is =mulat$ to be consum$ or adm9i/]$ "u 
! sup]vision ( a qualifi$ m$ical        
provid]1 = ! treatm5t ( conditions z    
recomm5d$ by ! ,advisory ,committee on  
,h]itable ,disord]s 9 ,newborns &       
,*ildr51 & ! m$ical equipm5t & supplies 
necess>y to adm9i/] su* food2  4  7,b7  
,def9ition ,section #ahfa ( ! ,social   
,security ,act 7#db ,u4,s4,c4 #aciex7 is
 am5d$ by add+ at ! end ! foll[+ new    
subsection3  7iii7 7#a7 ,! t]m m$ically 
necess>y food-- 7,a7 means a food :i* is
 =mulat$ to be consum$ or adm9i/]$      
ent]ally "u ! sup]vision ( a physician &
 :i* is int5d$ = ! specific diet>y      
managem5t ( a disease or condition = :i*
 di/9ctive nutritional requirem5ts1 bas$
 on recogniz$ sci5tific pr9ciples1 are  
e/abli%$ by m$ical evaluation2 &  7,b7  
includes nutritionally modifi$ c\nt]p>ts
 ( traditional foods & o!r =ms ( foods  

su* z =mulas1 pills1 capsules1 & b>s1 s 
long z consum$ or adm9i/]$ ent]ally4    
7#b7 ,= purposes ( p>agraph 7#a71 ! t]m 
ent]ally ref]s to consumption or        
adm9i/ration ?r\gh ! ga/ro9te/9al tract1
 :e!r orally or by tube4  4  7,c7       
,paym5t ,section #ahcc7;a77#a7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciel7a77#a77 is am5d$-- 7i7 by /rik+ &
 be=e 7,z72 &  7ii7 by ins]t+ be=e !    
semicolon at ! end ! foll[+3 1 & 7,,aa7 
) respect to m$ically necess>y food &   
ph>macological doses ( vitam9s & am9o   
acids "u section #ahfa7s77#b77;,,gg71 ! 
am\nts paid %all be #hj p]c5t ( ! less] 
( ! actual *>ge = ! s]vices or #he p]c5t
 ( ! am\nt det]m9$ "u ! fee s*$ule      
e/abli%$ "u section #ahdh7;b7 = ! same  
s]vices if furni%$ by a physician4  7#b7
 ,inclusion ( ph>macological doses (    
vitam9s & am9o acids z a cov]$ "p ,d    
drug  7,a7 ,9 g5]al ,section            
#ahfj;,d-#b7;e77#a7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajb7;e77#a77 is am5d$-- 7i7 9   

subp>agraph 7,a71 by /rik+ or at ! end2 
7ii7 9 subp>agraph 7,b71 by /rik+ !     
comma at ! end & ins]t+ 2 or2 &  7iii7  
by ins]t+ aft] subp>agraph 7,b7 ! foll[+
 new subp>agraph3  7,c7 ph>macological  
doses ( vitam9s & am9o acids us$ = !    
treatm5t ( inborn errors ( metabolism1 =
 ! treatm5t ( conditions z recomm5d$ by 
! ,advisory ,committee on ,h]itable     
,disord]s 9 ,newborns & ,*ildr5 & z     
prescrib$ by a qualifi$ m$ical provid]1 
4  7,b7 ,effective date ,! am5dm5ts made
 by subp>agraph 7,a7 %all apply to plan 
ye>s beg9n+ on or aft] ! date t is #f   
mon?s aft] date ( enactm5t ( ?is ,act4  
7b7 ,cov]age "u ! ,m$icaid program  7#a7
 ,9 g5]al ,section #aije ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acif;d7  
is am5d$-- 7,a7 9 subsection 7a7-- 7i7 9
 p>agraph 7#ab71 by ins]t+ includ+      
ph>macological doses ( vitam9s & am9o   
acids us$ = ! treatm5t ( inborn errors (
 metabolism1 = ! treatm5t ( conditions z
 recomm5d$ by ! ,advisory ,committee on 
,h]itable ,disord]s 9 ,newborns &       

,*ildr5 & z prescrib$ by a qualifi$     
m$ical provid]1 aft] prescrib$ drugs12  
7ii7 9 p>agraph 7#bh71 by /rik+ & at !  
end2  7iii7 by r$esignat+ p>agraph 7#bi7
 z p>agraph 7#cj72 &  7iv7 by ins]t+    
aft] p>agraph 7#bh7 ! foll[+ new        
p>agraph3  7#bi7 m$ically necess>y food 
7z def9$ 9 subsection 7ee77 & food      
modifi$ to be l[ prote9 t is =mulat$ to 
be consum$ or adm9i/]$ "u ! sup]vision (
 a qualifi$ m$ical provid]1 = ! treatm5t
 ( conditions z recomm5d$ by ! ,advisory
 ,committee on ,h]itable ,disord]s 9    
,newborns & ,*ildr51 & ! m$ical equipm5t
 & supplies necess>y to adm9i/] su*     
food2 &  2 &  7,b7 by add+ at ! end !   
foll[+ new subsection3  7ee7 ,m$ically  
necess>y food def9$  7#a7 ,9 g5]al ,=   
purposes ( subsection 7a77#bi71 ! t]m   
m$ically necess>y food-- 7,a7 means a   
food :i* is =mulat$ to be consum$ or    
adm9i/]$ ent]ally "u ! sup]vision ( a   
physician & :i* is int5d$ = ! specific  
diet>y managem5t ( a disease or         
condition = :i* di/9ctive nutritional   

requirem5ts1 bas$ on recogniz$ sci5tific
 pr9ciples1 are e/abli%$ by m$ical      
evaluation2 &  7,b7 includes            
nutritionally modifi$ c\nt]p>ts (       
traditional foods & o!r =ms ( foods su* 
z =mulas1 pills1 capsules1 & b>s1 s long
 z consum$ or adm9i/]$ ent]ally4  7#b7  
,ent]ally ,= purposes ( p>agraph 7#a71 !
 t]m ent]ally ref]s to consumption or   
adm9i/ration ?r\gh ! ga/ro9te/9al tract1
 :e!r orally or by tube4  4  7#b7       
,exception to rebate exclusion ,section 
#aibg7;d77#b77;,e7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acifr-#h7;d77#b77;,e77 is am5d$ by     
ins]t+ 1 ph>macological doses ( vitam9s 
& am9o acids us$ = ! treatm5t ( inborn  
errors ( metabolism1 = ! treatm5t (     
conditions z recomm5d$ by ! ,advisory   
,committee on ,h]itable ,disord]s 9     
,newborns & ,*ildr5 & z prescrib$ by a  
qualifi$ m$ical provid]1 aft] pr5atal   
vitam9s4  7#c7 ,con=m+ am5dm5t ,section 
#aijb7;a77#aj77;,a7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           

#acif;a7a77#aj77;,a77 is am5d$1 9 !     
matt] prec$+ clause 7i71 by /rik+ &     
7#bh7 & ins]t+ 7#bh71 & 7#bi74  7#d7    
,exception to effective date if ,/ate   
legislation requir$ ,9 ! case ( a ,/ate 
plan = m$ical assi/ance "u title ,,xix (
 ! ,social ,security ,act :i* !         
,secret>y ( ,heal? & ,human ,s]vices    
det]m9es requires ,/ate legislation 7o!r
 ?an legislation appropriat+ funds7 9   
ord] = ! plan to meet ! additional      
requirem5t impos$ by ! am5dm5ts made by 
?is subsection1 ! ,/ate plan %all n be  
reg>d$ z fail+ to comply ) ! requirem5ts
 ( su* title solely on ! basis ( its    
failure to meet ?is additional          
requirem5t be=e ! fir/ day ( ! fir/     
cal5d> qu>t] beg9n+ aft] ! close ( !    
fir/ regul> session ( ! ,/ate           
legislature t beg9s aft] ! date ( !     
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 su* session %all be deem$ to be a      
sep>ate regul> session ( ! ,/ate        

legislature4  7c7 ,cov]age "u ,,*ip     
7#a7 ,9 g5]al  7,a7 ,m$ically necess>y  
food ,section #bajc7;c7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#acig;cc7c77 is am5d$ by add+ at ! end !
 foll[+3  7#i7 ,m$ically necess>y food  
7,a7 ,9 g5]al ,! *ild heal? assi/ance   
provid$ to a t>get$ l[-income *ild "u ! 
plan %all include cov]age ( m$ically    
necess>y food & food modifi$ to be l[   
prote9 t is =mulat$ to be consum$ or    
adm9i/]$ "u ! sup]vision ( a qualifi$   
m$ical provid]1 = ! treatm5t (          
conditions z recomm5d$ by ! ,advisory   
,committee on ,h]itable ,disord]s 9     
,newborns & ,*ildr51 & ! m$ical equipm5t
 & supplies necess>y to adm9i/] su*     
food4  7,b7 ,def9itions ,9 ?is          
p>agraph-- 7i7 ! t]m m$ically necess>y  
food-- 7,i7 means a food :i* is =mulat$ 
to be consum$ or adm9i/]$ ent]ally "u ! 
sup]vision ( a physician & :i* is int5d$
 = ! specific diet>y managem5t ( a      
disease or condition = :i* di/9ctive    
nutritional requirem5ts1 bas$ on        

recogniz$ sci5tific pr9ciples1 are      
e/abli%$ by m$ical evaluation2 &  7,,ii7
 includes nutritionally modifi$         
c\nt]p>ts ( traditional foods & o!r =ms 
( foods su* z =mulas1 pills1 capsules1 &
 b>s1 s long z consum$ or adm9i/]$      
ent]ally2 &  7ii7 ! t]m ent]ally ref]s  
to consumption or adm9i/ration ?r\gh !  
ga/ro9te/9al tract1 :e!r orally or by   
tube4  4  7,b7 ,vitam9s & am9o acids    
,section #baaj7;a77#f7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acig;jj7a77#f77 is am5d$ by /rik+ &    
biologicals & ! adm9i/ration ( su* drugs
 & biologicals1 only if su* drugs &     
biologicals & ins]t+ 1 ph>macological   
doses ( vitam9s & am9o acids us$ = !    
treatm5t ( inborn errors ( metabolism1 =
 ! treatm5t ( conditions z recomm5d$ by 
! ,advisory ,committee on ,h]itable     
,disord]s 9 ,newborns & ,*ildr5 & z     
prescrib$ by a qualifi$ m$ical provid]1 
& biologicals1 & ! adm9i/ration ( su*   
drugs1 vitam9s & am9o acids1 &          
biologicals1 only if su* drugs1 vitam9s 

& am9o acids1 & biologicals4  7#b7      
,con=m+ am5dm5t ,section #bajc7;a7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acig;cc7a77 is am5d$1 9 ! matt] prec$+ 
p>agraph 7#a71 by /rik+ 1 & 7#g7 &      
ins]t+ 1 7#g71 & 7#i74  7#c7 ,exception 
to effective date if ,/ate legislation  
requir$ ,9 ! case ( a ,/ate *ild heal?  
plan = *ild heal? assi/ance "u title    
,,xxi ( ! ,social ,security ,act :i* !  
,secret>y ( ,heal? & ,human ,s]vices    
det]m9es requires ,/ate legislation 7o!r
 ?an legislation appropriat+ funds7 9   
ord] = ! plan to meet ! additional      
requirem5t impos$ by ! am5dm5ts made by 
?is subsection1 ! ,/ate *ild heal? plan 
%all n be reg>d$ z fail+ to comply ) !  
requirem5ts ( su* title solely on !     
basis ( its failure to meet ?is         
additional requirem5t be=e ! fir/ day ( 
! fir/ cal5d> qu>t] beg9n+ aft] ! close 
( ! fir/ regul> session ( ! ,/ate       
legislature t beg9s aft] ! date ( !     
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has

 a #b-ye> legislative session1 ea* ye> (
 su* session %all be deem$ to be a      
sep>ate regul> session ( ! ,/ate        
legislature4  7d7 ,availability (       
m$ically necess>y food1 food modifi$ ,to
 be l[ prote91 & relat$ items "u !      
,,tric>e program ,section #ajgg ( title 
#aj1 ,unit$ ,/ates ,code1 is am5d$--    
7#a7 9 subsection 7a77#h71 by /rik+     
includ+ & all t foll[s & ins]t+ 8includ+
 ! foll[+3  7,a7 ,well-baby c>e t       
includes "o scre5+ ( an infant = ! level
 ( lead 9 ! blood ( ! infant4  7,b7 ,9  
accordance ) subsection 7g71 m$ically   
necess>y food 7z def9$ 9 section        
#ahfa7;iii7 ( ! ,social ,security ,act7 
& food modifi$ to be l[ prote9 t is     
=mulat$ to be consum$ or adm9i/]$ "u !  
sup]vision ( a qualifi$ m$ical provid]1 
= ! treatm5t ( conditions z recomm5d$ by
 ! ,advisory ,committee on ,h]itable    
,disord]s 9 ,newborns & ,*ildr51 & !    
m$ical equipm5t & supplies necess>y to  
adm9i/] su* food4  7,c7 ,9 accordance ) 
subsection 7g71 ph>macological doses (  

vitam9s & am9o acids us$ = ! treatm5t ( 
inborn errors ( metabolism & o!r        
conditions z recomm5d$ by ! ,advisory   
,committee on ,h]itable ,disord]s 9     
,newborns & ,*ildr5 & z prescrib$ by a  
qualifi$ m$ical provid]4  2 &  7#b7 by  
add+ at ! end ! foll[+ new subsection3  
7g7 ,treatm5ts describ$ 9 subp>agraphs  
7,b7 & 7,c7 ( subsection 7a77#h7 may be 
provid$ "u ?is section to a pati5t      
reg>dless ( ! age ( ! pati5t4  4  7e7   
,cov]age "u ,,fehbp  7#a7 ,9 g5]al      
,section #hijd ( title #e1 ,unit$ ,/ates
 ,code1 is am5d$ by add+ at ! end !     
foll[+ new subsection3  7c7 7#a7 ,any   
heal? b5efits plan (f]$ "u ?is *apt]    
%all1 9 accordance ) p>agraph 7#b71     
include b5efits =-- 7,a7 m$ically       
necess>y food 7z def9$ 9 section        
#ahfa7;iii7 ( ! ,social ,security ,act7 
& food modifi$ to be l[ prote9 t is     
=mulat$ to be consum$ or adm9i/]$ "u !  
sup]vision ( a qualifi$ m$ical provid]1 
= ! treatm5t ( conditions z recomm5d$ by
 ! ,advisory ,committee on ,h]itable    

,disord]s 9 ,newborns & ,*ildr51 & !    
m$ical equipm5t & supplies necess>y to  
adm9i/] su* food2 &  7,b7 ph>macological
 doses ( vitam9s & am9o acids us$ = !   
treatm5t ( inborn errors ( metabolism1 =
 ! treatm5t ( conditions z recomm5d$ by 
! ,advisory ,committee on ,h]itable     
,disord]s 9 ,newborns & ,*ildr5 & z     
prescrib$ by a qualifi$ m$ical provid]4 
7#b7 ,b5efits = treatm5ts describ$ 9    
subp>agraphs 7,a7 & 7,b7 ( p>agraph 7#a7
 %all be provid$ "u su* a heal? b5efits 
plan to an individual reg>dless ( ! age 
( ! individual4  4  7#b7 ,effective date
 ,! am5dm5t made by p>agraph 7#a7 %all  
apply to contract ye>s beg9n+ aft] !    
date t is #i mon?s aft] ! date (        
enactm5t ( ?is ,act4  #d4 ,effective    
date ,subject to subsections 7b77#d7 &  
7c77#c7 ( section 7#c71 ! am5dm5ts made 
by section #c 7o!r ?an subsection 7e7 ( 
su* section7 %all apply to plan ye>s &  
contract ye>s beg9n+ aft] ! date t is #f
 mon?s aft] ! date ( enactm5t ( ?is     
,act4