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Dec. 8, 2016

TOPIC: Advocacy

Expansion of Medical Foods Coverage for Military Families Heads to the President, Having Passed in the Senate

Posted by Jennifer Huron

us-senateWe are pleased to announce that today that the United States Senate has passed the National Defense Authorization Act (S.2943) with language substantially expanding coverage for medical foods in the TRICARE program. This bill will now join the 21st Century Cures Act in moving to the President’s desk to be signed into law.

Medical foods are medically necessary nutrition essential for many rare disease patients to thrive. Patients with metabolic disorders such as PKU, or digestive disorders such as Eosinophilic Esophagitis and FPIES, require medical foods to survive. Those affected by these disorders often cannot eat regular foods found in grocery stores as they are often either missing enzymes needed to break down proteins, or are unable to digest certain components of normal foods.

Despite being essential to survival for individuals with these medical conditions, unfortunately medical foods are almost always under-covered by both public and private insurers, as they do not fit the standard definitions of medical treatment.

Today’s vote is a big first step in the right direction. Once enacted, TRICARE, the health care program of the United States Department of Defense Military Health System, will have one of the most expansive medical foods coverage policies in America.

Now, with this momentum, we hope to be able to expand coverage for medical foods in Medicare, Medicaid, and other public and private insurance programs. NORD’s goal is to ensure that, when supported by medical evidence, medical foods are covered by insurance the same as any other medical treatment.

Over the past year, NORD has joined forces with patient groups, and physician groups, such as the pediatric gastroenterologists, in working with the Armed Services Committees to advocate on behalf of TRICARE enrollees and families who rely on medical foods for the treatment and management of their rare diseases.

Thank you to Senators McCain, Graham, and Reed for being our champions in the Senate, and Congressmen Heck, Smith, Thornberry, and Davis in the House.

Most of all, thank you to our advocacy partners who helped lead the charge to make today a reality, and all the patients and patient advocates who lent their voice to this important cause.

In the past two days we have seen congress pass two groundbreaking pieces of legislation. It is times like these that patient advocates are reminded of the importance of their efforts to enact change.

 

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