By Caroline Kohler
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The Medical Nutrition Therapy Act of 2020 (the MNT Act) was introduced by Representatives Eliot Engel (D-NY) and Peter King (D-NY), with help from the Academy of Nutrition and Dietetics on May 22, 2020. Currently, the bill has been referred to the House Committee on Energy and Commerce and Committee on Ways and Means.
The MNT Act is one of the most significant pieces of legislation related to dietetics in recent years. If passed, the bill would expand Medicare coverage for medical nutrition therapy provided by dietitians.
This bill could have major positive implications for dietitians, so it’s important to lend your voice to its passage. The bill is currently at a critical point in its “lifecycle” so here’s what you need to know about the MNT Act of 2020.
What is the Medical Nutrition Therapy Act of 2020?
The Medical Nutrition Therapy Act of 2020 expands Medicare coverage for MNT beyond the current coverage only for diabetes, renal disease, and post-kidney transplant. Several provisions would greatly increase access to MNT for older adults on Medicare.
New Diseases and Conditions Covered
The MNT Act would require Medicare coverage for MNT for prediabetes, obesity, hypertension, dyslipidemia, malnutrition, eating disorders, cancer, celiac disease, HIV/AIDS, and “any disease related to unintentional weight loss.”
The Academy provided evidence of the effectiveness of MNT in preventing further complications and worsened quality of life to encourage members of Congress to require coverage for preventative MNT treatment.
If these conditions were to be covered by Medicare, older adults would be able to access outpatient nutrition counseling that could help them prevent worsened conditions. We nutrition students know that these conditions are common in older age and can be effectively improved with nutrition intervention!
Medicare is a unique program that offers coverage to all adults over the age of 65. People can choose to buy private insurance if they want to, but Medicare offers a safety net for folks who cannot afford to purchase private insurance. In this way, Medicare is a key source of healthcare support for low-income elders and allows all older adults to access the care they need to age well.
Flexibility for Expansion of Services
A clause in the MNT Act expressly gives the Secretary of Health and Human Services the power to add conditions to Medicare MNT coverage, if the Secretary deems MNT “to be medically necessary and appropriate for the prevention, management, or treatment of such disease or condition, consistent with any applicable recommendations of the United States Preventive Services Task Force [or] consistent with either protocols established by registered dietitians or nutrition professional organizations.”
This clause means that the Secretary would not need to ask Congress to create a bill to amend the Social Security Act again (as this bill would) when more evidence comes out to recommend another condition for MNT coverage. The Secretary could instead gather recommendations from health professionals and the Academy and make the decision without needing to go through Congress.
Increased Opportunities for Referral to MNT Services
Currently, only physicians can refer patients to a registered dietitian for MNT services covered by Medicare (renal and diabetes care). But, we know that not every individual sees a physician for their primary care – some people may see other medical professionals who recognize the need for MNT.
Under the MNT Act, nurse practitioners, physician assistants, clinical nurse specialists and psychologists (in the case of eating disorders) could also make referrals for these services. This is another provision that increases accessibility to medical nutrition therapy.
Potential to Influence Future Coverage
Services covered by Medicare are often seen as the standard by which other insurance plans base their coverage. If Medicare covers MNT services, private insurance companies may be more inclined to cover it too.
Broader coverage for MNT services required by law also grants a sort of “official recognition” of the evidence that supports the importance of registered dietitians in patient care. The MNT Act of 2020 has the potential to be the first step in better insurance coverage for dietetics services – which would mean better access to preventive care for patients and more consistent reimbursement for dietitians.
Where the Medical Nutrition Therapy Act of 2020 Stands Now
Current as of 6/20/2020
The MNT Act was “referred to committee” on May 22. This is a critical point: House committees are small groups of Representatives who work on making the bill ready for debate in the House. They discuss potential problems and ideas and make sure that it is financially feasible.
But you might have also heard the phrase “died in committee” – this is the idea that it’s easy for bills to lose traction when they’re referred to the committees because the members don’t work on it. It’s a way of getting the bill to “go away” without having to stage a vote and publicly show its rejection.
The MNT Act is in the hands of the House Committee on Energy and Commerce and Committee on Ways and Means. The Energy and Commerce Committee is more responsible for it. (The Ways and Means Committee has a say in every bill to make sure it fits in the Congressional budget.)
It’s been stalled there for almost a month, so encouraging the Representatives on that committee to remember it and work on it is very important right now.
How To Take Action on the MNT Act of 2020
Here’s where action gets tricky: committees involve very specific Representatives – 55 of them in the case of the Energy and Commerce Committee. If your Representative does not serve on this committee, you can’t really lobby the committee directly. (You can technically contact any member of Congress, but they’re more likely to listen to their constituents. But if you like making phone calls, go for it!)
(Not sure who your Representative is? Use this tool to find out!)
If your Rep does serve on the committee, you have a special voice in getting this bill moving! Call your Representative’s office and tell them (or, more likely, their staff) that they should prioritize moving this bill to a vote. Explain your educational and professional background, cite data if you have it, and most importantly, share concise, meaningful personal experiences.
Even if you are not from one of the districts represented on the committee, you can still help! Representatives communicate frequently (just like any coworkers). You can encourage your Representative to nudge their colleagues on the committee to work on it. If they know this bill is important to their constituents, they are more incentivized to help it move forward.
Also, don’t forget to include your friends and family in your action. More voices equal more power! Bonus points if you can find a friend or family member who lives in a district represented on the committee.
The MNT Act of 2020 can have major implications for the future of dietetics and elder care in this country. Whether you have 10 minutes to call your Representative, an hour to reach out to friends and family to ask for their support, or even 5 minutes to spread the word on social media – every bit of support for this bill will help advance our profession!