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If passed, the Medical Nutrition Therapy Act could expand Medicare Part B to cover medical nutrition therapy services for patients with cancer, who need to maintain their strength and keep a health body weight during treatment. ACCCBuzz shares more about this legislation and why its benefits are essential for oncology.
By Matt Devino, MPH
Care for individuals with multiple chronic conditions is particularly costly for the Medicare population, in which two-thirds of beneficiaries have two or more chronic conditions. Medical nutrition therapy (MNT) is a low-cost, effective component of disease management and prevention when it is part of a comprehensive medical treatment plan. Services under MNT include an initial nutrition and lifestyle assessment, individual and/or group nutritional therapy services, help managing the lifestyle factors that affect a patient’s diabetes, and follow-up visits to check on the patient’s progress in managing their diet. Currently, Medicare covers MNT services only for the treatment of patients with chronic kidney disease, diabetes mellitus, or kidney transplantation (within the past 36 months), with services provided by registered dietitian nutritionists (RDNs) or nutrition professionals through physician referral.
In May 2021, U.S. Senators Susan Collins (R-ME) and Gary Peters (D-MI) introduced the Medical Nutrition Therapy Act, a bipartisan legislation that would expand Medicare Part B to cover MNT services for additional conditions, including cancer, prediabetes, eating disorders, malnutrition, gastrointestinal diseases (e.g., celiac disease), cardiovascular disease, HIV/AIDS, and other diseases or conditions that cause unintentional weight loss. The bill will further authorize the U.S. Secretary of Health and Human Services to expand MNT coverage for other diseases or conditions, as deemed medically necessary, and allow clinical nurse specialists, nurse practitioners, physician assistants, and psychologists to refer patients to MNT services.
The Consequences of Poor Nutrition
MNT helps patients with cancer maintain their strength, keep a healthy body weight, keep body tissue healthy, and decrease therapy side effects. According to Kelay E. Trentham, MS, RDN, CSO, a board-certified oncology dietitian, “…adult cancer patients with poor nutritional status experience decreased tolerance to cancer treatment, higher hospital admission or readmission rates, increased length of hospital stay, decreased quality of life, and increased mortality.”
Malnutrition is not uncommon among patients with cancer, as the disease and its various treatments can affect patients’ appetite, smell, taste, and ability to eat food or absorb nutrients necessary for their health and recovery. In a startling statistic, the NCI reported that several studies show “malnutrition in 30% to 85% of patients with cancer” at some point during their treatment. Guidance by an RDN can positively impact weight, blood pressure, blood lipids, and blood sugar control, which may impact whether or not a patient remains on schedule with a recommended treatment plan for their cancer.
Expanded access to MNT through Medicare can also help address inequities in access to care and improve the health and well-being of vulnerable adult populations more likely to suffer from chronic disease. Access to MNT is also vital for individuals from marginalized racial and ethnic groups, who have historically faced disparities in chronic disease rates due to systemic inequalities, food insecurity, reduced access to care, and now COVID-19.
ACCC members can help raise awareness of the 2021 MNT Act by: