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Floor Speech

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Ms. COLLINS. Mr. President, I rise today to introduce the Medical Nutrition Therapy Act of 2026, along with my colleague from Michigan Senator Peters. Our bill will expand Medicare beneficiaries' access to medical nutrition therapy, or MNT, which is a cost-effective component of treatment for obesity, diabetes, hypertension, and other chronic conditions. Increasing access to MNT should be part of the strategy to improve disease management and prevention for America's seniors. The Medical Nutrition Therapy Act would make two important changes to support patients, improve health outcomes, and reduce unnecessary healthcare costs.

First, the bill would expand Medicare Part B coverage of outpatient medical nutrition therapy services to several currently uncovered diseases or conditions, including prediabetes, obesity, high blood pressure, high cholesterol, malnutrition, eating disorders, cancer, HIV/AIDS, gastrointestinal diseases including celiac disease, and cardiovascular disease. Currently, Medicare Part B only covers outpatient MNT for diabetes, renal disease, and post-kidney transplant.

Second, the bill would allow more types of providers--including nurse practitioners, physician assistants, clinical nurse specialists, and psychologists--to refer patients to MNT. Right now, only physicians may refer patients to dieticians for medical nutrition therapy. Expanding the types of providers who make these referrals would be especially significant for patients in a rural State like Maine where an NP or PA may be one's trusted primary care provider.

MNT counseling is provided by registered dietitian nutritionists, RDNs, as part of a collaborative healthcare team. It is evidence-based and has been proven to positively affect weight, blood pressure, blood lipids, and blood sugar control. Nutritional counseling by RDNs is recommended by the National Lipid Association to promote long-term adherence to an individualized, heart-healthy diet. Through MST, individuals benefit from in-depth, individualized nutrition assessments. Followup visits help reinforce important behavior and lifestyle changes and increase compliance.

Seniors deserve improved access to this cost-effective medical treatment, but many older adults are missing out under the current Medicare policy. I heard from a dietitian in rural Washington County, ME, who is the only part-time dietitian in the county and works at a federally qualified health center, FQHC. One of her patients is an elderly man with severe tooth decay requiring a modified personalized meal plan. He lost 40 pounds in 1 year despite being cleared for any gastrointestinal or other underlying medical condition that could have caused this extreme weight loss. He became clinically malnourished. Finally, his primary care provider referred him to the dietitian at the FQHC for medical nutrition therapy with a diagnosis of failure to thrive.

Because this patient, however, did not have a diagnosis of diabetes or renal disease, the FQHC at which he received treatment will not receive Medicare reimbursement for the three 60-minute medical nutrition therapy sessions that the dietitian provided. At his third and final session, the patient shared that this dietitian was the most helpful provider with whom he had ever met. He is no longer afraid of eating and has more good days enjoying meals with family and friends.

Another patient from Maine, who is a Medicare beneficiary, was treated for severe obesity with gastric bypass surgery. This patient was unable to afford out of pocket costs to receive post-operative medical nutrition therapy. He struggled with post-operative diet advancement, which led to hospitalization for severe dehydration and failure to thrive within the first 3 months after surgery. One year after surgery, this patient had severe nutritional anemia requiring iron infusion and monthly vitamin B-12 injections. This tragic situation could have been prevented if the MNT he needed had been covered by Medicare. Early treatment with MNT can prevent serious health complications and chronic conditions, particularly in older adults.

In addition to the human cost, there is a financial one: the impact on the Medicare Program. This should not come as a surprise since the health and economic effects of chronic diseases are staggering. According to the U.S. Centers for Disease Control and Prevention, 90 percent of the $4.9 trillion that the United States spends annually on healthcare goes to the treatment of people with chronic diseases and mental health conditions. Preventing chronic diseases, or managing symptoms when prevention is not possible is an effective way to reduce these costs. This is particularly important for the Medicare Program as more than two-thirds of seniors on Medicare live with multiple chronic conditions. As one registered dietitian nutritionist in Maine told me, ``We all know a dollar spent on prevention saves many health care dollars in the long run and is the right thing to do for our seniors at a time when they have limited budgets.''

The Medical Nutrition Therapy Act of 2025 is supported by the Academy of Nutrition and Dietetics, the American Diabetes Association, the Endocrine Society, and UsAgainstAlzheimer's. I urge my colleagues to support this important legislation to improve access to cost-effective medical treatment for Medicare patients with chronic diseases.

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