Introduction of the Medicare Medical Nutrition Therapy Act of 2007

Floor Speech

INTRODUCTION OF THE MEDICARE MEDICAL NUTRITION THERAPY ACT OF 2007 -- (Extensions of Remarks - June 22, 2007)

* Mr. BECERRA. Madam Speaker, I rise today to introduce the bipartisan Medicare Medical Nutrition Therapy Act (MMNTA) of 2007. This legislation is cosponsored by my friends and colleagues Representatives MICHAEL CASTLE (R-DE), DIANA DEGETTE (D-CO) and MARK KIRK (R-IL).

* The MMNTA of 2007 authorizes Medicare to expand the use of medical nutrition therapy to treat any disease for which empirical research has shown clinical value. The American Dietetic Association has endorsed this important legislation.

* In 2000, the Institute of Medicine (IOM) of the National Academy of Sciences found that medical nutrition therapy is effective as part of a comprehensive approach to the treatment and management of the following conditions: diabetes, heart failure, kidney failure, dyslipidemia (a total cholesterol condition as well as other abnormalities in blood lipid levels) and hypertension. In response to this study, Congress allowed Medicare to reimburse medical nutrition therapy for beneficiaries with diabetes and renal diseases.

* Specifically, the benefit Congress added includes an initial assessment of a beneficiary's nutrition and lifestyle, nutrition counseling, information regarding managing lifestyle factors that affect diet and follow-up visits to monitor the beneficiary's progress. Medicare covers three hours of one-on-one counseling services the first year, and two hours each year after that. The benefit provides additional treatment hours when the beneficiary's condition, treatment, or diagnosis changes and a physician refers the beneficiary. A physician must prescribe these services and renew them yearly if continuing treatment is needed.

* In 2004, the Department of Health and Human Services (HHS) released a report that reiterated that medical nutrition therapy is effective as part of a comprehensive approach to the management and treatment of dyslipidemia (referred to as hyperlidemia in the HHS report) and hypertension. This study's corroboration of 10M's earlier findings demonstrates that many Medicare beneficiaries who could benefit from this treatment cannot access it through Medicare.

* Moreover, expanding the use of medical nutrition therapy has the potential to be a cost effective means of providing health care. Recently, the Pfizer Corporation piloted a 6-month nutrition and exercise intervention program for employees with hyperlipidemia. The study concluded that this intervention reduced Low-density Lipoprotein (LDL) cholesterol 12 months later. And, the participating employees had their risk for heart disease reduced by 19 percent. The intervention could save an estimated $728,722 annually if offered to the entire Pfizer population.

* Unfortunately, the method that Congress established to determine eligibility for medical nutrition therapy is flawed. Congress specified in law which diseases should receive medical nutrition therapy instead of leaving that judgment to the Center for Medicare and Medicaid Services (CMS) as is the custom for other benefits provided by the program.

* CMS has the experts and infrastructure to make these important decisions based on empirical research. As part of its administration of the Medicare program, CMS determines the items and services that are reasonable and necessary for the diagnosis or treatment of an illness or injury suffered by Medicare beneficiaries. CMS makes national coverage determinations by evaluating medical literature and data and information on the effectiveness and appropriateness of medical items and services that are being considered for Medicare coverage. During this process, the public has the opportunity to provide comments. In some cases, CMS' own research is supplemented by an outside assessment and/or consultation with a Medicare Evidence Development & Coverage Advisory Committee (MedCAC). A MedCAC consists of outside experts who supplement CMS career staff examination of an issue. These committees examine the strength of available evidence and make recommendations to CMS on coverage decisions.

* By passing this legislation, Congress would increase access to medical nutrition therapy to Medicare beneficiaries through a thoughtful and scientific approach. I urge my colleagues to support this bill and ensure that Medicare beneficiaries have the appropriate access to medical nutrition therapy.

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