,,ii  #aafth ,,congress  #b;d ,session  
,s4 #dejd  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,august #f1    
#bjbj,ms4 ,collins 7for herself and ,mr4
 ,peters7 introduced the following bill2
 which was read twice and referred to   
the ,committee on ,finance  ,a ,,bill   
,to amend title ,,xviii of the ,social  
,security ,act to expand the            
availability of medical nutrition       
therapy services under the ,medicare    
program4  #a4 ,short title ,this ,act   
may be cited as the ,medical ,nutrition 
,therapy ,act of #bjbj4  #b4 ,expanding 
the availability of medical nutrition   
therapy services under the ,medicare    
program  7a7 ,in general ,section #ahfa 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #aciex7 is amended-- 7#a7 in  
subsection 7s77#b77,v71 by striking in  
the case of and all that follows through
 organizations2 and  7#b7 in subsection 
7vv7-- 7,a7 in paragraph 7#a7-- 7i7 by  
striking disease management and         
inserting the prevention1 management1 or

 treatment of a disease or condition    
specified in paragraph 7#d72  7ii7 by   
inserting or by a physician assistant1  
nurse practitioner1 or clinical nurse   
specialist 7as such terms are defined in
 subsection 7aa77#e771 or1 in the case  
of such services furnished to manage    
such a disease or condition that is an  
eating disorder1 by a clinical          
psychologist 7as defined by the         
,secretary7 before the period at the    
end2 and  7iii7 by adding at the end the
 following new sentence3 ,such term     
shall not include any such services     
furnished to an individual for the      
prevention1 management1 or treatment of 
a renal disease if such individual is   
receiving maintenance dialysis for which
 payment is made under section #ahha42  
and  7,b7 by adding at the end the      
following new paragraph3  7#d7 ,for     
purposes of paragraph 7#a71 the diseases
 and conditions specified in this       
paragraph are the following3 7,a7       
,diabetes and prediabetes4  7,b7 ,a     

renal disease4  7,c7 ,obesity 7as       
defined for purposes of subsection      
7yy77#b77;,c7 or as otherwise defined by
 the ,secretary74  7,d7 ,hypertension4  
7,e7 ,dyslipidemia4  7,f7 ,malnutrition4
  7,g7 ,eating disorders4  7,h7 ,cancer4
  7,i7 ,celiac disease4  7,j7 ,,hiv4    
7,k7 ,,aids4  7,l7 ,any other disease or
 condition-- 7i7 specified by the       
,secretary relating to unintentional    
weight loss2  7ii7 for which the        
,secretary determines the services      
described in paragraph 7#a7 to be       
medically necessary and appropriate for 
the prevention1 management1 or treatment
 of such disease or condition1          
consistent with any applicable          
recommendations of the ,united ,states  
,preventive ,services ,task ,force2 or  
7iii7 for which the ,secretary          
determines the services described in    
paragraph 7#a7 are medically necessary1 
consistent with either protocols        
established by registered dietitians or 
nutrition professional organizations or 

with accepted clinical guidelines       
identified by the ,secretary4  4  7b7   
,exclusion modification ,section        
#ahfb7;a77#a7 is amended-- 7#a7 in      
subparagraph 7,o71 by striking and at   
the end2  7#b7 in subparagraph 7,p71 by 
striking the semicolon at the end and   
inserting 1 and2 and  7#c7 by adding at 
the end the following new subparagraph3 
7,q7 in the case of medical nutrition   
therapy services 7as defined in section 
#ahfa7vv771 which are not furnished for 
the prevention1 management1 or treatment
 of a disease or condition specified in 
paragraph 7#d7 of such section2  4  7c7 
,effective date ,the amendments made by 
this section shall apply with respect to
 items and services furnished on or     
after ,january #a1 #bjba4