Public Policy at State Capital - Senator Durbin and Friends

Champion Nutrition - 2007 Summary
Read this article in the IDA Spring 2007 Bulletin

April 23rd through April 25th 2007, approximately 20 dietitians, students, and interns from Illinois, attended the Public Policy Workshop in Washington D.C. Every year, the ADA holds this conference to empower and educate the membership on the importance of legislation to our profession. This year, the theme was Champion Nutrition. In 2006, the Public Policy Workshop educated members on the reauthorization of the Older American Act as well as reauthorization of the Ryan White CARE Act. As a result of the efforts of ADA members contacting their Representative and Senators, dietitians were written into both of those pieces of legislation. If you would like more information on either of these bills, go to the ADA website and look under the advocacy section.

The 2007 workshop mainly focused on two topics. The first topic was legislation dealing with MNT. Currently, ADA is working on getting co-sponsors for two pieces of legislation. The first bill will be introduced in the House in the coming weeks by Representative Xavier Becerra of California. Senator Jeff Bingaman’s bill dealing with the same issue has been introduced in the Senate and is bill S. 1161. This bill asks Congress to give Medicare the authority to expand Medicare’s MNT benefit. Currently, Medicare patients are only able to have access to a dietitian if they have diabetes or renal disease. These benefits became available to Medicare beneficiaries January 1, 2002. Since then, ADA has tried various ways to get other disease states covered. Unfortunately, they have not been able to do so because of the cost associated with the benefit. Technically, this current bill is not asking Congress to spend any money. Instead, it just shifts the power from Congress to the Center for Medicare and Medicaid Services (CMS) to make the decision of what is “necessary and reasonable.” In fact, the new bill would result in a net saving for Medicare because dietitians are paid at 85 percent the rate of what a physician would charge for similar services. For example, if a patient needed nutrition information regarding hyperlipidemia, under the present law, a physician would provide that service. If this new bill gets passed, Medicare could allow dietitians to perform this service at a cost savings.

The next piece of legislation dealing with MNT is a bill that is being sponsored in the House by Representative Diana DeGette of Colorado. ADA is currently looking for a sponsor in the Senate. This bill asks Congress to add pre-diabetes to the MNT coverage under Medicare. As members of the Illinois delegation went to meet with our Senators and Representatives, we discussed with them that 60% of Medicare beneficiaries have diabetes. We also talked about the 2002 Diabetes Prevention Program Study which indicated that people over the age of 60, who made lifestyle changes, reduced the development of diabetes by 71 percent. Under the current Medicare law, they screen and identify people with pre-diabetes, but they do not provide beneficiaries with access to services to prevent diabetes. Additionally, there is also a bill in the Senate which is sponsored by Senator Charles Schumer called S. 755. This bill asks the Senate to require state Medicaid programs to cover the screening and treatment, including MNT, of diabetes.

The last bill covered at the workshop was the Farm Bill. At this point, you may be asking what do dietitians have to do with Farm Bill. The answer is a lot. This bill deals with the USDA and its funding. When members of Illinois went to the Hill, we were addressing several issues in relation to the Farm Bill. We were asking to provide funds to establish the National Institute for Food and Agriculture. We also asked them to preserve and adequately fund the USDA’s Human Nutrition Research Centers that are presently operating. The Dietary Guidelines fall under this bill as well. ADA has taken a position that they would like the see the Guidelines issued every ten years instead of every five, as they are now. This would provide time to build public acceptance as well as provide time for more thorough research into the Guidelines impact. We also asked for improvements to USDA’s food assistance programs that serve those in need. We are asking that they help beneficiaries to use food stamps for diets consistent with the Dietary Guidelines through incentives and nutrition education.

Hopefully, after reading this article, you have come to realize the importance that legislation has on the dietetics profession. It is my hope that you will be inspired to champion nutrition, not just where you work, but in the areas you live. The best way you can champion nutrition is to get involved. It takes all of us to working together to help get legislation passed. Please consider contacting your United States Representative and Senators and asking them to be a co-sponsor of these bills. I assure you, that if we as dietitians do not let our voices be heard, there will be many other groups who will. The reason dietitians did not have Medicare coverage for so many years is because when the original Medicare bill passed in 1965, dietitians did not let their voices be heard. If you would like to get involved, if you would like more information, or you have questions or concerns, I encourage you to contact any me at eomalley@att.net or any member of our Government Affairs Team. Their contact information is located on the Illinois Dietetic Association website.

updated: October 13, 2007