12/15/99 Medical Nutrition Therapy: Effective and Necessary -- American Dietetic Association Commends National Academy of Sciences' Institute of Medicine for Findings of Medicare Study

Medical Nutrition Therapy: Effective and Necessary -- American Dietetic Association Commends National Academy of Sciences' Institute of Medicine for Findings of Medicare Study

Press Release December 15, 1999

Contact: Bridget McManamon, Lori Ferme or Tom Ryan
E-mail: media@eatright.org
(Please do not publish/broadcast contact information)

CHICAGO -- Millions of Americans covered by Medicare could receive high-quality, lifesaving nutrition therapy services if the recommendations of studies released Wednesday, December 15, by the National Academy of Sciences' Institute of Medicine are enacted by Congress.

The American Dietetic Association, the world's largest organization of food and nutrition professionals, commends IOM on the conclusions of its new studies on extending Medicare to cover services for which benefits are now excluded or limited.

The IOM report, "The Role of Nutrition in Maintaining Health in the Nation's Elderly: Evaluating Coverage of Nutrition Services for the Medicare Population," recommends that medical nutrition therapy, "upon referral by a physician, be a reimbursable benefit for Medicare beneficiaries" and that it be covered "whether or not expanded coverage reduces overall Medicare expenditures."

"Medical nutrition therapy" refers to the comprehensive nutrition services provided by registered dietitians as part of the health-care team.

Medicare Part A now covers medical nutrition therapy for inpatient care. A bill before Congress would extend medical nutrition therapy coverage to outpatient settings as well.

"The results of this study are wonderful news for all Americans, especially those who are covered by Medicare," said ADA President Ann Gallagher, a Ft. Wayne, Ind., registered dietitian.

"Medical nutrition therapy has been proven effective in saving lives, preventing diseases, improving people's overall quality of care and saving millions of dollars in health-care costs."

The IOM study identifies registered dietitians as "the single identifiable group with (the) requirements necessary to be directly reimbursed as a provider of nutrition therapy."

And the study recommends that the Health Care Financing Administration "as well as accreditation and licensing groups reevaluate existing reimbursement systems and regulations for nutrition services along the continuum of care (acute care, ambulatory care, home care, skilled nursing and long-term care settings) to determine the adequacy of care delineated by such standards."

"Speaking for my fellow 70,000 ADA members, we are extremely gratified that IOM has recognized that dietitians are an indispensable part of the health-care team," Gallagher said.

"No other health-care professionals have the education, clinical training, continuing education and credentials to conduct medical nutrition therapy for patients."

Medical nutrition therapy is effective in treating and controlling heart disease, stroke, diabetes, high cholesterol and other life-threatening conditions. Patients require fewer hospitalizations and medications and have fewer complications.

Earlier independent studies have shown the costs of extending Medicare to cover outpatient nutrition services would be offset by billions of dollars in savings in other treatment areas in as few as four years. A study done for the Department of Defense estimated that more than $3 million could be saved after one year if medical nutrition therapy was included in the Tricare benefit program for military personnel.

The IOM study "is a significant step ahead for patients who can achieve significantly improved health outcomes through informed and appropriate nutrition," Gallagher said. "While we at ADA are pleased by the findings, we are hardly surprised.

"Registered dietitians know the linkages between appropriate nutrition and overall health. There are times when a patient's nutritional status is a life-or-death matter. Private health insurers like Aetna USHealthcare already have recognized how important medical nutrition therapy is to patient outcomes.

"It is time that public programs, like Medicare, stop shortchanging patients of these services."

There is now no consistent pattern of coverage for nutrition services, either under Medicare or in the private sector. ADA hopes Congress will recognize this high level of support for medical nutrition therapy coverage as it considers options to reform Medicare in hopes of securing the long-term solvency and security of the program.

For the second consecutive year -- in two different sessions of Congress -- a bipartisan majority of the House of Representatives has signed on as co-sponsors of the Medicare Medical Nutrition Therapy Act. The bill is sponsored in the House by Rep. Nancy L. Johnson (R.-Conn.) and in the Senate by Sen. Jeff Bingaman (D-N.M.) and Larry Craig (R-Idaho).

Of more than 2,500 bills introduced in the 106th Congress, just 14 have achieved majority co-sponsorship in the House. Only two of them, including HR 1187, are health-related. While achieving a majority of co-sponsors does not guarantee passage of legislation, it significantly elevates the issue in the eyes of congressional leadership, Gallagher said.

Key House and Senate committees have been awaiting the IOM report, requested by Congress in the Balanced Budget Act of 1997, prior to considering addition of medical nutrition therapy coverage to Medicare.

"The Institute of Medicine has clarified the need for Medicare to cover these invaluable services," Gallagher said. "This is good for patients and their families as well as the entire Medicare program. Now it is up to Congress to make it happen."

With nearly 70,000 members, the Chicago-based American Dietetic Association is the world's largest organization of food and nutrition professionals. ADA serves the public by promoting nutrition, health and well-being.

For the most timely, complete food and nutrition information, visit ADA's Web site: http://www.eatright.org/.

Editor's note: ADA spokespeople -- registered dietitians from all parts of the country -- are available to comment on the NAS study and to discuss the benefits of medical nutrition therapy. Members of ADA's government affairs office are available to discuss political and public policy aspects, including the Medicare Medical Nutrition Therapy Act. Call 800-877-1600, ext. 4802, 4894 or 4769.

See Ann Gallagher's memo to the Association
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