119-hr2495

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2495 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 2495

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 program.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 March 31, 2025

 Ms. Chu (for herself, Mr. Fitzpatrick, Mr. Tonko, and Mr. Bacon) 
 introduced the following bill; which was referred to the Committee on 
 Energy and Commerce, and in addition to the Committee on Ways and 
 Means, for a period to be subsequently determined by the Speaker, in 
 each case for consideration of such provisions as fall within the 
 jurisdiction of the committee concerned

_______________________________________________________________________

 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 program.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Nutrition Counseling Aiding Recovery 
for Eating Disorders Act of 2025'' or the ``Nutrition CARE Act of 
2025''.

SEC. 2. FINDINGS.

 Congress finds the following:

    (1) 28,800,000 individuals in the United Sates, or 9 
 percent of the national population, will have an eating 
 disorder in their lifetime. It is estimated that 1,619,300 to 
 2,080,600 individuals on Medicare part B are affected by an 
 eating disorder, including 420,500 to 560,700 beneficiaries who 
 identify as Black, Indigenous, or People of Color.

    (2) 10,200 deaths per year in the United States occur as a 
 direct result of an eating disorder, equating to 1 death every 
 52 minutes. Eating disorders have one of the highest mortality 
 rates of all mental illness due to serious medical 
 comorbidities such as stroke, diabetes, and gastric rupture, in 
 addition to the fact that longitudinal studies have found that 
 the suicide risk for those with an eating disorder is 23 times 
 the expected risk.

    (3) Eating disorders can be successfully treated with care 
 encompassing the 4 pillars of successful treatment: medical, 
 psychiatric, therapy, and medical nutrition therapy. In 
 general, Medicare provides some, but not all, care necessary 
 for eating disorders treatment. It doesn't cover medical 
 nutrition therapy at the outpatient level and provides no 
 coverage at the intensive outpatient or residential treatment 
 levels.

    (4) Eating disorders are expensive. The yearly economic 
 cost of eating disorders is $64,700,000,000, with families and 
 individuals experiencing an economic loss of $23,500,000,000 
 per year. Each year, eating disorders are directly responsible 
 for 23,560 inpatient hospitalizations costing $209,700,000 and 
 53,918 emergency room visits costing $29,300,000.

    (5) 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 disorders, 
 including cardiac, metabolic, gastric, and bone conditions. 
 Early diagnosis and proper treatment of this population is 
 essential.

SEC. 3. PROVIDING COVERAGE OF MEDICAL NUTRITION THERAPY SERVICES FOR 
 INDIVIDUALS WITH EATING DISORDERS UNDER THE MEDICARE 
 PROGRAM.

 

Section 1861 of the Social Security Act (42 U.S.C. 1395x) is 
amended--

    (1) in subsection

    (s)

    (2)
            (V) --
        (A) by redesignating clauses
            (i) through
            (iii) as 
 subclauses
            (I) through
            (III) , respectively, and 
 adjusting the margins accordingly;
        (B) in subclause
            (III) , as so redesignated, by 
 striking the semicolon at the end and inserting ``; 
 or'';
            (C) by striking ``beneficiary with diabetes'' and 
 inserting the following: ``beneficiary--
 ``
            (i) with diabetes''; and
            (D) by adding at the end the following new clause:
 ``
            (ii) beginning January 1, 2026, with an eating 
 disorder (as defined by the Secretary in accordance 
 with most recent edition of the Diagnostic and 
 Statistical Manual of Mental Disorders published by the 
 American Psychiatric Association);''; and

    (2) in subsection
            (vv) --
        (A) in paragraph

    (1) --
            (i) by inserting ``(including management of 
 an eating disorder (as defined for purposes of 
 subsection

    (s)

    (2)
            (V) 
            (ii) ))'' after ``disease 
 management''; and
            (ii) by striking ``which are furnished by'' 
 and all that follows through the period and 
 inserting ``which are furnished--
 ``
        (A) by a registered dietitian or nutrition 
 professional (as defined in paragraph

    (2) );
 ``
        (B) pursuant to a referral by--
 ``
            (i) a physician (as defined in subsection

    (r)

    (1) ); or
 ``
            (ii) a psychologist (or other mental 
 health professional to the extent authorized 
 under State law); and
 ``
            (C) in the case of such services furnished to an 
 individual for the purpose of management of such an 
 eating disorder, at the times specified in paragraph

    (4) .''; and
        (B) by adding at the end the following new 
 paragraph:
 ``

    (4)
        (A) For purposes of paragraph

    (1)
            (C) , the times specified in 
this paragraph are, with respect to medical nutrition therapy services 
furnished to an individual for purposes of management of an eating 
disorder, at least the following:
 ``
            (i) 13 hours (including a 1-hour initial assessment and 
 12 hours of reassessment and intervention) during the 1-year 
 period beginning on the date such individual is first furnished 
 such services.
 ``
            (ii) Subject to subparagraph
        (B) , 4 hours during each 
 subsequent 1-year period.
 ``
        (B) 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
        (A)
            (ii) as the Secretary determines 
appropriate.''.
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