,,ii #aaith ,,congress #b;d ,session ,s4 #cicd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #bf1 #bjbf,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 #bjbf4 #b4 ,findings ,congress finds the following3 7#a7 ,over two-thirds of ,medicare fee-for-service beneficiaries have #b or more chronic conditions1 many of which can be prevented1 delayed1 treated1 or managed through nutrition4 7#b7 ,individuals from many racial and ethnic minority backgrounds are more likely to be diagnosed with chronic diseases such as diabetes1 prediabetes1 chronic kidney disease1 end-stage renal disease1 and obesity4 7#c7 ,coverage for medical nutrition therapy is only available to ,medicare ,part ,b beneficiaries with diabetes or a renal disease1 despite medical nutrition therapy being part of the standard of care1 in clinical guidelines1 and medically necessary for many more chronic conditions4 7#d7 ,medical nutrition therapy has been shown to be a cost-effective component of treatment for obesity1 diabetes1 hypertension1 dyslipidemia1 ,,hiv infection1 unintended weight loss in older adults1 and other chronic conditions4 #c4 ,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 striking by a physician and all that follows through the period at the end and inserting the following3 by-- 7,a7 a physician 7as defined in subsection 7r77#a772 7,b7 a physician assistant 7as defined in subsection 7aa77#e772 7,c7 a nurse practitioner 7as defined in subsection 7aa77#e772 7,d7 a clinical nurse specialist 7as defined in subsection 7aa77#e77;,b772 or 7,e7 in the case of such services furnished to manage such a disease or condition that is an eating disorder1 a clinical psychologist 7as defined by the ,secretary74 2 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 ,diabetes4 7,b7 ,prediabetes4 7,c7 ,a renal disease4 7,d7 ,obesity 7as defined for purposes of subsection 7yy77#b77;,c7 or as otherwise defined by the ,secretary74 7,e7 ,hypertension4 7,f7 ,dyslipidemia4 7,g7 ,malnutrition4 7,h7 ,eating disorders4 7,i7 ,cancer4 7,j7 ,gastrointestinal diseases1 including ,celiac disease4 7,k7 ,,hiv4 7,l7 ,,aids4 7,m7 ,cardiovascular disease4 7,n7 ,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 either with protocols established by registered dietitian 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 in years beginning on or after the date that is #b years after the date of the enactment of this ,act4