A5332

An Act concerning nutrition services for certain Medicaid and NJ FamilyCare enrollees and supplementing Title 30 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. As used in this act:

“Dietician” shall have the same meaning as provided in section 3 of P.L.2019, c.331 (C.45:16B-3).

“Licensed nutritionist” shall have the same meaning as provided in section 3 of P.L.2019, c.331 (C.45:16B-3).

“Medicaid” means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).

“Medical nutrition therapy” shall have the same meaning as provided in section 3 of P.L.2019, c.331 (C.45:16B-3).

“Medically tailored nutrition services” means a suite of services that are prescribed by a medical professional and designed by a dietician or a licensed nutritionist in order to prevent, manage, or treat an individual’s diet-related illness. Medically tailored nutrition services may include, but are not limited to, the provision of medical nutrition therapy, medically tailored meals, medically tailored food, and subsidies for the purchase of nutritious foods.

“Medically tailored foods” means non-prepared, perishable and nonperishable grocery items and produce, which are selected by a dietician or a licensed nutritionist as part of a treatment plan to address an individual’s diagnosed medical condition, and which are intended to provide partial or near-complete nutrition.

“Medically tailored meals” means ready-to-eat or fully prepared meals and snacks that are designed by a dietician or a licensed nutritionist as part of a treatment plan to address an individual’s diagnosed medical condition, and which are intended to provide complete or near-complete nutrition.

“Near-complete nutrition” means foods and meals that provide greater than 50 percent of an individual’s daily caloric needs.

“NJ FamilyCare” means the program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.).

“Nutritious food subsidies” means vouchers for free or discounted, nutrient-dense foods which are intended to provide supplemental nutrition, and which may require further preparation before consumption.

2. a. Notwithstanding the provision of any law to the contrary, the Medicaid program and the NJ FamilyCare program shall provide coverage for the following medically tailored nutrition services, when prescribed by an enrollee’s licensed physician or primary healthcare provider:

(1) medically tailored meals, in a quantity of at least ten meals per week, for an enrollee diagnosed with the following medical conditions:

(a) congestive heart failure;

(b) type 2 diabetes;

(d) renal disease;

(2) medically tailored foods, in an amount sufficient to prepare 14 meals per week, for an enrollee diagnosed with the following medical conditions:

(a) type 2 diabetes; or

(b) obesity;

(3) nutritious food subsidies, in the amount of $25 per week or greater, for an enrollee diagnosed with the following medical conditions:

(a) pre-diabetes;

(b) overweight; or

(4) medical nutrition therapy, in an amount and duration to be determined by the prescribing physician, for an enrollee diagnosed with the following medical conditions:

(a) diabetes; or

(b) renal disease.

b. All medically tailored nutrition services, provided pursuant to paragraph a. of this section, shall be designed and overseen by a dietician or a licensed nutritionist as part of a treatment plan to address an enrollee’s medical conditions.

3. The Commissioner of Human Services shall apply for such federal waivers or state plan amendments as are necessary to implement the provisions of this act and to continue to secure federal financial participation for State expenditures under the federal Medicaid program and the Children’ s Health Insurance Program.

4. The Commissioner of Human Services, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410

(C.52:14B-1 et seq.), shall adopt such rules and regulations as may be necessary to implement the provisions of this act.

5. This act shall take effect on the first day of the fourth month next following the date of enactment, except that the Commissioner of Human Services may take any anticipatory administrative action in advance thereof as may be necessary for the implementation of this act.

STATEMENT

This bill requires the Medicaid and NJ FamilyCare programs to cover medically tailored nutrition services, when prescribed by a medical professional and designed by a dietician or a licensed nutritionist, in order address an enrollee’s diet-related medical conditions. It is the intent of the bill’s sponsor to provide enrollees with the nutritional support necessary to help prevent, manage, or treat diet-related illness or medical conditions.

The bill provides Medicaid and NJ FamilyCare coverage for a minimum of 10 medically tailored meals per week for enrollees who have been diagnosed with congestive heart failure, type 2 diabetes, chronic obstructive pulmonary disease, or renal disease. Medically tailored meals are defined under the bill as being ready-to-eat or fully prepared meals and snacks that are designed by a dietician or a licensed nutritionist as part of a treatment plan to address an individual’s diagnosed medical conditions, and which are intended to provide complete or near-complete nutrition.

The bill also requires Medicaid and NJ FamilyCare coverage for medically tailored foods, in an amount sufficient for the preparation of 14 meals per week, for enrollees diagnosed with type 2 diabetes or obesity. The bill defines medically tailored foods as being non-prepared, perishable and nonperishable grocery items and produce, which are selected by a dietician or a licensed nutritionist as part of a treatment plan, and which are intended to provide partial or near-complete nutrition.

Under the bill, the Medicaid and NJ FamilyCare programs are to provide subsidies for nutritious foods, in the amount of $25 per week or greater, for enrollees who have been diagnosed with pre-diabetes, overweight, or hypertension. The food items that enrollees may purchase using these subsidies may require further preparation before consumption.

The bill additionally provides Medicaid and NJ FamilyCare coverage for medical nutrition therapy, in an amount and for a duration to be determined by the prescribing physician, for certain enrollees diagnosed with diabetes or renal disease.

The bill further stipulates that all medically tailored nutrition services provided under the Medicaid and NJ FamilyCare programs be designed and managed by a dietician or a licensed nutritionist as part of a treatment plan to address an enrollee’s medical condition.

Studies show that dietary interventions, such as medically tailored meals, help reduce the number of hospital admissions, emergency department visits, and nursing home admissions for patients with diet-related illnesses. According to data from the Food is Medicine Coalition, a research and advocacy organization, six months of dietary interventions can reduce an individual’s medical costs by 16 percent.

As of February 2023, moreover, the federal Centers for Medicare and Medicaid Services, which administers the federal Medicaid and CHIP programs, has approved Medicaid demonstration programs in Oregon, Massachusetts, and Arkansas that provide healthy food and nutrition supports for certain enrollees.

According to the federal Centers for Disease Control and Prevention, only one in ten adults consumes the recommended number of servings of fruit and vegetable, as included in the federal Dietary Guidelines for Americans. Results of a study conducted by researchers at Tufts University show that the majority of children and youth between the ages of two and 19 years consume a diet that nutrition researchers would describe as being of “poor quality,” while less than one percent consume a diet that researchers would consider to be of “ideal quality.”

A diet rich in fruits, vegetables, whole grains, and lean protein is associated with a reduced risk of heart disease; conversely, a diet high in refined carbohydrates, added sugars, alcohol, and processed meats is associated with a higher risk for cardiovascular disease and early death. Researchers have found that highly processed foods, which are associated with increased caloric intake and weight gain, comprise nearly 60 percent of the average consumer’s diet and account for 90 percent of added sugar consumption.

It is the sponsor’s belief that individuals living with particular primary and comorbid health conditions may also have specific dietary needs that must be met in order for these individuals to manage their health.