Nutrition CARE Act of 2025
- Sponsor
- Rep. Chu, Judy [D-CA-28]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Mar 31, 2025
Bottom line
The bill aims to improve access to comprehensive care for Medicare beneficiaries with eating disorders by adding medical nutrition therapy to covered services, addressing a current gap in Medicare's treatment offerings.
What it actually does
This bill expands Medicare Part B coverage to include medical nutrition therapy (MNT) services for individuals diagnosed with eating disorders, effective January 1, 2026. It specifies that these services must be provided by registered dietitians or nutrition professionals, referred by a physician or mental health professional, and sets minimum coverage limits of 13 hours in the first year and 4 hours in subsequent years, with flexibility for the Secretary to apply further limitations.
Proponents argue
Proponents argue that eating disorders are serious, life-threatening conditions with high mortality rates and significant economic costs, and that MNT is a critical, currently uncovered pillar of effective treatment. They contend that providing MNT coverage will lead to better health outcomes, reduce costly inpatient hospitalizations and emergency room visits, and ensure a more holistic approach to care for vulnerable Medicare beneficiaries, including those from diverse racial and ethnic backgrounds.
Opponents contend
Potential opponents might raise concerns about the increased costs to the Medicare program associated with expanding coverage for a new service. They may also question the sufficiency or appropriateness of the specified hour limits for MNT, arguing that either they could lead to over-utilization or be inadequate for the complex needs of some patients, potentially leading to inefficient use of resources.
The bill is short and clearly written, making it accessible for a quick and thorough understanding of its provisions within the given timeframe.
Section 3(1) and Section 3(2)(A)(i)
Expansion of Medicare Coverage for Medical Nutrition Therapy to Include Eating Disorders
This provision amends the Social Security Act to include eating disorders as a condition for which medical nutrition therapy (MNT) services are covered under Medicare Part B. Currently, MNT is primarily covered for diabetes and renal disease. This change means that starting January 1, 2026, Medicare beneficiaries diagnosed with an eating disorder will be able to receive MNT services.
Supporters argue
Supporters argue this expansion is crucial because MNT is a recognized, evidence-based component of comprehensive eating disorder treatment, which is currently a significant gap in Medicare coverage. They highlight that this will improve health outcomes and potentially reduce more expensive acute care interventions.
Critics contend
Critics may express concern that expanding coverage for new conditions could lead to increased Medicare expenditures without clear evidence of long-term cost savings, potentially straining the program's financial sustainability.
Tradeoffs
The provision balances the need to provide comprehensive care for a serious health condition against the potential for increased federal healthcare spending. It also addresses the tension between current limited coverage and the recognized multi-disciplinary approach to eating disorder treatment.
Section 3(2)(A)(ii)
Specification of MNT Providers and Referral Requirements
This part of the bill specifies that medical nutrition therapy services for eating disorders must be furnished by a registered dietitian or a nutrition professional. Furthermore, these services must be provided based on a referral from a physician or a psychologist, or another mental health professional if authorized by state law. This ensures that MNT is integrated into a broader medical or mental health treatment plan.
Section 3(2)(B)
Establishment of Service Hour Limitations for MNT for Eating Disorders
This provision sets specific minimum hour limits for MNT services covered for eating disorders. For the first year of treatment, beneficiaries are covered for at least 13 hours (including a 1-hour initial assessment and 12 hours of reassessment and intervention). In subsequent years, at least 4 hours of MNT are covered annually. The Secretary of Health and Human Services is granted authority to apply additional reasonable limitations for subsequent years.
The definition of 'eating disorder' for the purpose of Medicare coverage is delegated to the Secretary of Health and Human Services, who must define it 'in accordance with most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association'.
Section 3(1)(D) and Section 3(2)(A)(i)
Why it matters:Delegating specific definitions to regulatory agencies is standard legislative practice, allowing for flexibility and adaptation to evolving medical consensus without requiring new legislation.
Case for: Supporters argue that this approach ensures the definition remains current with medical understanding and clinical best practices, allowing for timely updates without legislative delays. It leverages expert knowledge from the American Psychiatric Association.
Case against: Critics might argue that delegating the definition to the Secretary could lead to variations in coverage or interpretation over time, potentially impacting access to care if the definition becomes too narrow or if future administrations alter it without direct Congressional oversight.
Estimated impact: The specific definition adopted by the Secretary will directly determine which Medicare beneficiaries are eligible for MNT services for eating disorders, impacting millions of individuals.