Medical Nutrition Therapy

Medical Nutrition Therapy

Expand Medicare Medical Nutrition Therapy Benefits

Medical Nutrition Therapy (MNT) involves the assessment of the nutritional status of patients with a condition, illness or injury that puts them at risk. This includes review and analysis of medical and diet history, laboratory values, and anthropometric measurements. Based on the assessment, nutrition modalities most appropriate to manage the condition or treat the injury are chosen and include the following:

  • Diet modification and counseling leading to the development of a personal diet plan to achieve nutritional goals desired health outcomes.
  • Specialized nutrition therapies including supplementation with medical foods for those unable to obtain adequate nutrients through food intake only, eternal nutrition delivered via tub feeding into the gastrointestinal tract for those unable to ingest or digest food, and parenteral nutrition delivered via intravenous infusion for those unable to absorb nutrients.

In 2000 the Congress passed a law that for the first time made Registered Dietitians eligible providers of MNT under Medicare. However, the Congress limited the scope of MNT to patients with diabetes and renal diseases.

In 2007, the American Dietetic Association is supporting the expansion of Medicare MNT benefits in two different ways:

ADA is supports passage of The Medicare Medical Nutrition Therapy Act. This legislation will give the Centers for Medicare and Medicaid Services (CMS) the authority to use the National Coverage Determination process to determine what, if any, new diseases, conditions, or disorders also should be eligible for MNT. The bill does not mandate any expansion of the benefit; it only gives CMS the authority using a "necessary and reasonable" standard to review the scientific evidence to determine if additional coverage is warranted.

Expansion of the Medicare MNT benefit could allow patients with pre-diabetes or certain cardiovascular diseases to receive the therapy necessary to prevent the progression of their condition. The scientific evidence is clear that dietary modification, along with other lifestyle changes, is the most cost-effective treatment for these conditions.

ADA also strongly supports a bill to expand the definition of diabetes to include pre-diabetes for coverage of Medicare MNT. There are 54 million people with pre-diabetes in America. For a significant number of people with pre-diabetes, intervening early can reverse elevated blood glucose levels to normal range and prevent diabetes and its complications completely.

Preventing diabetes and its complications will save lives and money. Diabetes is unique because its complications and their tremendous costs are preventable with currently available medical treatment. In 2002, the Diabetes Prevention Program study found that participants (all of whom were at increased risk of developing type 2 diabetes) who made lifestyle changes, reduced their risk of getting type 2 diabetes by 58 percent; and people aged 60 and older, reduced the development of diabetes by 71 percent. AHRQ has demonstrated that $2.5 billion in hospitalization costs alone could be saved by providing seniors with appropriate primary care.