,,ii  #aaith ,,congress  #ast ,session  
,s4 #aiga  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #e1      
#bjbe,ms4 ,hassan 7for herself1 ,ms4    
,murkowski1 ,ms4 ,klobuchar1 and ,mrs4  
,capito7 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 provide coverage of   
medical nutrition therapy services for  
individuals with eating disorders under 
the ,medicare program4  #a4 ,short title
 ,this ,act may be cited as the         
,nutrition ,counseling ,aiding ,recovery
 for ,eating ,disorders ,act of #bjbe or
 the ,nutrition ,,care ,act of #bjbe4   
#b4 ,findings ,congress finds the       
following3 7#a7 #bh1hjj1jjj individuals 
in the ,united ,sates1 or #i percent of 
the national population1 will have an   
eating disorder in their lifetime4 ,it  
is estimated that #a1fai1cjj to         
#b1jhj1fjj individuals on ,medicare part
 ,b are affected by an eating disorder1 

including #dbj1ejj to #efj1gjj          
beneficiaries who identify as ,black1   
,indigenous1 or ,people of ,color4  7#b7
 #aj1bjj deaths per year in the ,united 
,states occur as a direct result of an  
eating disorder1 equating to #a death   
every #eb minutes4 ,eating disorders    
have one of the highest mortality rates 
of all mental illness due to serious    
medical comorbidities such as stroke1   
diabetes1 and gastric rupture1 in       
addition to the fact that longitudinal  
studies have found that the suicide risk
 for those with an eating disorder is   
#bc times the expected risk4  7#c7      
,eating disorders can be successfully   
treated with care encompassing the #d   
pillars of successful treatment3        
medical1 psychiatric1 therapy1 and      
medical nutrition therapy4 ,in general1 
,medicare provides some1 but not all1   
care necessary for eating disorders     
treatment4 ,it doesn't cover medical    
nutrition therapy at the outpatient     
level and provides no coverage at the   

intensive outpatient or residential     
treatment levels4  7#d7 ,eating         
disorders are expensive4 ,the yearly    
economic cost of eating disorders is    
#fd1gjj1jjj1jjj1 with families and      
individuals experiencing an economic    
loss of #bc1ejj1jjj1jjj per year4 ,each 
year1 eating disorders are directly     
responsible for #bc1efj inpatient       
hospitalizations costing #bji1gjj1jjj   
and #ec1iah emergency room visits       
costing #bi1cjj1jjj4  7#e7 ,eating      
disorders in the elderly are            
particularly serious because chronic    
disorders or diseases may already       
compromise a patient's health and make a
 patient more prone to serious          
comorbidities associated with eating    
disorders1 including cardiac1 metabolic1
 gastric1 and bone conditions4 ,early   
diagnosis and proper treatment of this  
population is essential4  #c4 ,providing
 coverage of medical nutrition therapy  
services for individuals with eating    
disorders under the ,medicare program   

,section #ahfa of the ,social ,security 
,act 7#db ,u4,s4,c4 #aciex7 is amended--
 7#a7 in subsection 7s77#b77,v7-- 7,a7  
by redesignating clauses 7i7 through    
7iii7 as subclauses 7,i7 through        
7,,iii71 respectively1 and adjusting the
 margins accordingly2  7,b7 in subclause
 7,,iii71 as so redesignated1 by        
striking the semicolon at the end and   
inserting 2 or2  7,c7 by striking       
beneficiary with diabetes and inserting 
the following3 beneficiary-- 7i7 with   
diabetes  2 and  7,d7 by adding at the  
end the following new clause3  7ii7     
beginning ,january #a1 #bjbf1 with an   
eating disorder 7as defined by the      
,secretary in accordance with most      
recent edition of the ,diagnostic and   
,statistical ,manual of ,mental         
,disorders published by the ,american   
,psychiatric ,association72  2 and  7#b7
 in subsection 7vv7-- 7,a7 in paragraph 
7#a7-- 7i7 by inserting 7including      
management of an eating disorder 7as    
defined for purposes of subsection      

7s77#b77,v77ii777 after disease         
management2 and  7ii7 by striking which 
are furnished by and all that follows   
through the period and inserting 8which 
are furnished--  7,a7 by a registered   
dietitian or nutrition professional 7as 
defined in paragraph 7#b772  7,b7       
pursuant to a referral by-- 7i7 a       
physician 7as defined in subsection     
7r77#a772 or  7ii7 a psychologist 7or   
other mental health professional to the 
extent authorized under ,state law72 and
  7,c7 in the case of such services     
furnished to an individual for the      
purpose of management of such an eating 
disorder1 at the times specified in     
paragraph 7#d74  2 and  7,b7 by adding  
at the end the following new paragraph3 
7#d7 7,a7 ,for purposes of paragraph    
7#a77;,c71 the times specified in this  
paragraph are1 with respect to medical  
nutrition therapy services furnished to 
an individual for purposes of management
 of an eating disorder1 at least the    
following3 7i7 #ac hours 7including a   

#a-;hour initial assessment and #ab     
hours of reassessment and intervention7 
during the #a-year period beginning on  
the date such individual is first       
furnished such services4  7ii7 ,subject 
to subparagraph 7,b71 #d hours during   
each subsequent #a-year period4  7,b7   
,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      
7,a77ii7 as the ,secretary determines   
appropriate4  4