,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #cajh  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,may #aa1 #bjba,ms4   
,kelly ( ,ill9ois 7= h]self & ,mr4      
,upton7 introduc$ ! foll[+ bill2 :i* 0  
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = 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 am5d title      
,,xviii ( ! ,social ,security ,act to   
exp& ! availability ( m$ical nutrition  
!rapy s]vices "u ! ,m$ic>e program4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,m$ical ,nutrition ,!rapy ,act ( #bjba4 
#b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7
 ,ov] two-?irds ( ,m$ic>e fee-=-s]vice  
b5efici>ies h two or m *ronic           
conditions1 _m ( :i* c be prev5t$1      
delay$1 treat$1 or manag$ ?r\gh         
nutrition4  7#b7 ,individuals f _m      
racial & e?nic m9ority backgr\nds are m 
likely to be diagnos$ ) *ronic diseases 

su* z diabetes1 pr$iabetes1 *ronic      
kidney disease1 end-/age r5al disease1 &
 obesity4  7#c7 ,! ,c5t]s = ,disease    
,control & ,prev5tion f9ds t individuals
 are at an increas$ risk ( sev]e illness
 f ,,covid-#ai if !y h canc]1 *ronic    
kidney disease1 diabetes1 he>t          
conditions su* z heal? failure or       
coron>y art]y disease1 or obesity4  7#d7
 ,cov]age = m$ical nutrition !rapy is   
only available to ,m$ic>e "p ,b         
b5efici>ies ) diabetes or a r5al        
disease1 despite m$ical nutrition !rapy 
be+ "p ( ! /&>d ( c>e1 9 cl9ical        
guidel9es1 & m$ically necess>y = _m m   
*ronic conditions4  7#e7 ,m$ical        
nutrition !rapy has be5 %[n to be a     
co/-effective compon5t ( treatm5t =     
obesity1 diabetes1 hyp]t5sion1          
dyslipidemia1 ,,hiv infection1 un9t5d$  
weight loss 9 old] adults & o!r *ronic  
conditions4  #c4 ,exp&+ ! availability (
 m$ical nutrition !rapy s]vices "u !    
,m$ic>e program  7a7 ,9 g5]al ,section  
#ahfa ( ! ,social ,security ,act 7#db   

,u4,s4,c4 #aciex7 is am5d$-- 7#a7 9     
subsection 7s77#b77,v71 by /rik+ 9 !    
case ( & all t foll[s ?r\gh             
organizations2 &  7#b7 9 subsection     
7vv7-- 7,a7 9 p>agraph 7#a7-- 7i7 by    
/rik+ disease managem5t & ins]t+ !      
prev5tion1 managem5t1 or treatm5t ( a   
disease or condition specifi$ 9 p>agraph
 7#d72 &  7ii7 by /rik+ by a physician &
 all t foll[s ?r\gh ! p]iod at ! end &  
ins]t+ ! foll[+3 by a-- 7,a7 physician  
7z def9$ 9 subsection 7r77#a772  7,b7   
physician assi/ant2  7,c7 nurse         
practition]2  7,d7 cl9ical nurse        
speciali/ 7z def9$ 9 subsection         
7aa77#e77;,b772 or  7,e7 9 ! case ( su* 
s]vices furni%$ to manage su* a disease 
or condition t is an eat+ disord]1 a    
cl9ical psy*ologi/ 7z def9$ by !        
,secret>y74 ,su* t]m %all n include any 
s]vices furni%$ to an individual = !    
prev5tion1 managem5t1 or treatm5t ( a   
r5al disease if su* individual is       
receiv+ ma9t5ance dialysis = :i* paym5t 
is made "u section #ahha4 2 &  7,b7 by  

add+ at ! end ! foll[+ new p>agraph3    
7#d7 ,= purposes ( p>agraph 7#a71 !     
diseases & conditions specifi$ 9 ?is    
p>agraph are ! foll[+3 7,a7 ,diabetes & 
pr$iabetes4  7,b7 ,a r5al disease4  7,c7
 ,obesity 7z def9$ = purposes (         
subsection 7yy77#b77;,c7 or z o!rwise   
def9$ by ! ,secret>y74  7,d7            
,hyp]t5sion4  7,e7 ,dyslipidemia4  7,f7 
,malnutrition4  7,g7 ,eat+ disord]s4    
7,h7 ,canc]4  7,i7 ,ga/ro9te/9al        
diseases1 includ+ celiac disease4  7,j7 
,,hiv4  7,k7 ,,aids4  7,l7 ,c>diovascul>
 disease4  7,m7 ,any o!r disease or     
condition-- 7i7 specifi$ by ! ,secret>y 
relat+ to un9t5tional weight loss2  7ii7
 = :i* ! ,secret>y det]m9es ! s]vices   
describ$ 9 p>agraph 7#a7 to be m$ically 
necess>y & appropriate = ! prev5tion1   
managem5t1 or treatm5t ( su* disease or 
condition1 consi/5t ) any applicable    
recomm5dations ( ! ,unit$ ,/ates        
,prev5tive ,s]vices ,task ,=ce2 or      
7iii7 = :i* ! ,secret>y det]m9es !      
s]vices describ$ 9 p>agraph 7#a7 are    

m$ically necess>y1 consi/5t ) ei!r      
protocols e/abli%$ by regi/]$ dietitians
 or nutrition pr(essional organizations 
or ) accept$ cl9ical guidel9es id5tifi$ 
by ! ,secret>y4  4  7b7 ,exclusion      
modification ,section #ahfb7;a77#a7 is  
am5d$-- 7#a7 9 subp>agraph 7,o71 by     
/rik+ & at ! end2  7#b7 9 subp>agraph   
7,p71 by /rik+ ! semicolon at ! end &   
ins]t+ 1 &2 &  7#c7 by add+ at ! end !  
foll[+ new subp>agraph3  7,q7 9 ! case (
 m$ical nutrition !rapy s]vices 7z def9$
 9 section #ahfa7vv771 :i* are n furni%$
 = ! prev5tion1 managem5t1 or treatm5t (
 a disease or condition specifi$ 9      
p>agraph 7#d7 ( su* section2  4  7c7    
,effective date ,! am5dm5ts made by ?is 
section %all apply ) respect to items & 
s]vices furni%$ on or aft] ,janu>y #a1  
#bjbc4