Public Policy and Advocacy


ASPEN advocates on behalf of the field of clinical nutrition to drive improvements in clinician experience and patient outcomes. Our scope includes high priority issues pertaining to nutrition support, including working in coalition with other like-minded organizations, as appropriate. Our advocacy objectives include working with the U.S. Congress, the Executive Branch (including HHS, NIH, regulatory agencies, CMS, and AHRQ), public/private groups, and the courts. The objectives of the ASPEN Public Policy and Advocacy Program are to:

  • Improve the quality and safety of all patients/consumers receiving nutrition support
  • Advocate for fair reimbursement to ensure that beneficiaries of government funded health programs receive the highest quality nutrition support care
  • Sponsor the concept of a fair marketplace that does not jeopardize the provision of safe and quality nutrition support
  • Advocate for and support initiatives to better define, diagnose, and treat disease related malnutrition

Call to Action: Priority Issues

Medical Nutrition Therapy (MNT), Bills S.1536/H.R.3108

Medical Nutrition Therapy (MNT) Act of 2021: Take Action Now!
Help expand MNT and support equitable access to nutrition care in the US.
Click here for a letter template and contact your senators and representatives today!

Companion bill S.1536/ H.R.3108 introduced in the 117th Congress in May 2021, expands Medicare coverage of medical nutrition therapy (MNT) services. Currently, Medicare covers MNT only for individuals with diagnosed diabetes or kidney disease and post-kidney transplant and requires a physician referral. The bill extends coverage to individuals with other diseases and conditions, including malnutrition, prediabetes, obesity, eating disorders, cancer, and HIV/AIDS, hypertension, dyslipidemia, gastrointestinal diseases, cardiovascular disease, and other conditions causing unintended weight loss. This legislation also allows nurse practitioners, physician assistants, clinical nurse specialists, and psychologists to refer patients for MNT.  
  • S.1536 is sponsored by Sen.Collins, Susan M. [R-ME] and has 7 cosponsors (updated 3/21/2022)
  • H.R.3108 is sponsored by Rep. Kelly, Robin L. [D-IL-2] and currently has 28 cosponsors (updated 3/21/2022)

Medical Nutrition Equity Act, S.2013/H.R. 3783

Medical Nutrition Equity Act: Take Action Now!
Help expand coverage for medically necessary foods for those with digestive or metabolic disorders.
Click here for a letter template and contact your senators or representatives today!

A campaign by Patients & Providers for Medical Nutrition Equity, a coalition whose members include ASPEN and more than 40 other provider and patient organizations, led to the reintroduction of the Medical Nutrition Equity Act ( S.2013/ H.R.3783) in the 117th Congress in June 2021. The bill seeks to expand coverage under Medicare, Medicaid and other federal health care programs and private health insurance to include foods, vitamins, and individual amino acids that are medically necessary for the management of certain digestive and metabolic disorders and conditions.
  • S.2013 is sponsored by Sen. Casey, Robert P. Jr [D-PA] and currently has 19 co-sponsors (updated 3/21/2022)
  • H.R.3783 is sponsored by Rep. McGovern, James P. [D-MA-2] and currently has 80 co-sponsors (updated 3/21/2022)

Safe Step Act, S.464/H.R.2163
Reintroduced in the 117th Congress is the Safe Step Act ( S.464/ H.R.2163) in February and March, respectively. The purpose of this legislation is to improve step therapy protocols and ensure patients are able to safely and efficiently access the best treatment for them. The bill requires a group health plan to establish and exception to medication step-therapy protocol in specified cases. The bill also requires a group health plan to implement and make readily available a clear process for an individual to request an exception to the protocol, including required information and criteria for granting an exception. The bill further specifies timelines under which plans must respond to such requests.

  • S.464 is sponsored by Sen. Murkowski, Lisa [R-AK] and currently has 30 co-sponsors (updated 3/21/2022)
  • H.R.2163 is sponsored by Rep. Ruiz, Raul [D-CA-36] and currently has 114 co-sponsors (updated 3/21/2022)

Revised EN and PN Medicare LCD
New LCDs for EN and PN were updated in September 2021. Additional information can be found here: Enteral Nutrition; Parenteral Nutrition. A summary of the updates is provided by Bill Noyes, Sr. Vice President Reimbursement Policy at the National Home Infusion Association and Penny Allen, National Director, Nutrition Support Optum Infusion Pharmacy and Chair of the ASPEN Public Policy Committee in a webinar entitled “ Update on Medicare’s Coverage Criteria for Parenteral and Enteral Nutrition.”

Patient Access to Medical Foods Act H.R. 56
Re-introduced in the 117th Congress in January 2021 is the Patient Access to Medical Foods Act, H.R. 56. This bill provides for coverage of medical foods under Medicare, Medicaid, the Children's Health Insurance Program, and TRICARE. The bill also requires private health insurance providers to cover medical foods. Generally, a medical food is a food prescribed by a physician for the dietary management of a disease or condition. The bill also expands this definition to include a food prescribed as a therapeutic option when a physician determines that traditional therapies are inappropriate for the patient. This bill is intended to amend the Orphan Drug Act to recognize Medical Foods and assign them a National Drug Code (NDC) to improve reimbursement.

  • H.R.56 is sponsored by Rep. Biggs, And [R-AZ-5] and currently has no co-sponsors (updated 3/21/2022) 

Preserving Patient Access to Home Infusion Act S.2652
In August 2021, bipartisan legislation was introduced in the US Senate in the 117th Congress that will ensure Medicare patients maintain access to home infusion therapies that require the use of an infusion pump.  The Preserving Patient Access to Home Infusion Act provides technical clarifications that removes the physical presence requirement from Medicare’s current home infusion therapy benefit, ensuring payment regardless of whether a health care professional is present in the patient’s home. The legislation also acknowledges the full scope of professional services delivered by home infusion clinicians, including essential pharmacist services. The act also permits nurse practitioners and physician assistants to establish and review a home infusion plan of care, in addition to a physician.

  • S.2652 is co-sponsored by Sen. Mark Warner [D-VA] and Sen Tim Scott [R-SC] and currently has 3 co-sponsors (updated 3/21/2022)