Senate Bill S1571A

                                 
BILL NUMBER: S1571A

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:

To provide medically tailored meals and medical nutrition therapy by a
certified dietitian or certified nutritionist for the purpose of disease
management.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1: Creates a new PHL 365-a (jj) providing Medicaid coverage of
medically tailored meals and medical nutrition therapy for individuals
limited in activities of daily living by one or more chronic conditions.

Section 2: Determines the bill shall take effect one hundred eighty days
              

after it shall have become law.

 
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, and medically tailored
meals indicated by such therapy including home-delivered meals.

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

A study by 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 than the control group's
hospitalization costs, 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 a day for a hospital bed.
In other words, preventing one day of hospitalization covers the cost of
half a year of medically tailored meals.

 
PRIOR LEGISLATIVE HISTORY:

2017-2018: A9863 Gottfried/No Same-As

2019-2020: S3458A/A2794B Gottfried

 
FISCAL IMPLICATIONS:

This measure would provide a cost-savings in reduced hospitalizations
and institutionalizations.

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