BILL NUMBER: S4790

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the social services law, in relation to medical assist-
ance coverage for medically tailored meals and medical nutrition therapy
for the purpose of disease management

 
PURPOSE:

Provides coverage for medically tailored meals.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 adds a new paragraph (kk) to subdivision 2 of section 365-a of
the social services law as it relates to medically tailored meals.  This
section defines "medically tailored meals and medical nutrition therapy"
which are used to treat one or more chronic conditions for an individual
who is limited in theirr activities of daily living.

Section 2 provides the effective date.
              

 
JUSTIFICATION:

Appropriate food and nutrition are critical to management of chronic
illness. Maintaining immune function, increasing absorption of medica-
tions, and maintaining healthy body weight can help manage costly
diseases such as heart disease, diabetes, hypertension, COPD, HIV/AIDS,
and cancer. Food and nutrition services include medical nutritional
therapy and the medically tailored food that accompanies it. Medical
nutrition therapy involves diagnostic therapy and counseling on disease
management by a certified dietitian or certified nutritionist as well as
medically tailored meals indicated by such therapy, including home-de-
livered meals.

Lack of adequate nutrition is a significant predictor of hospitaliza-
tion, re-hospitalization, and increased length of a hospital stay. In a
Clinical Nutrition Study, malnutrition was evident in up to one-third of
inpatients and led to poor hospitalization outcomes, survival rates, and
increased cost of care.  This study reported hospital stays to be 50%
longer in malnourished patients, who were also nearly twice as likely to
be readmitted within 15 days. The average inpatient hospitalization cost
for malnourished patients was 24% higher than average and nutrition-spe-
cific Diagnosis Related Groups (DRGs) are among the top ten reasons that
Medicare beneficiaries are readmitted to the hospital.

A study by the Metropolitan Area Neighborhood Nutrition Alliance
(MANNA), a Philadelphia food and nutrition services agency, compared
health care costs of MANNA clients to a control group.

The results showed that on the MANNA program, clients' average monthly
healthcare costs fell 62% within the first three months that they
received food and nutritional services and 60% for HIV/AIDS patients.
If hospitalized, MANNA's clients had 30% lower hospitalization costs
than the control group's, 37% shorter stays, and 20% higher discharges
to the home rather than an institution.


Compared to the cost of hospitalizations or institutionalizations, food
and nutritional services are inexpensive. A person can receive a home-
delivered diet tailored to their unique medical circumstances for $20
per day, compared to several thousand dollars per day for a hospital
bed. In other words, preventing one day of hospitalization covers the
cost of half a year of medically tailored meals.

 
LEGISLATIVE HISTORY:

2017-2018: A9863 Gottfried/No Same-As

2019-2020: S3458A/A2794B Gottfried

2021-2022: S1571/A195A Gottfried

 
FISCAL INIRLICATIONS:

This measure would provide cost-savings by reducing hospitalizations and
institutionalizations.

 
EFFECTIVE DATE:
One hundred eighty days after it shall have become law.