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Dec. 2, 2016

TOPIC: Advocacy

House Votes to Expand Medical Foods Coverage for Military Families

Posted by Jennifer Huron

seal_of_the_united_states_house_of_representatives-svgWe are pleased to announce that today the House of Representatives has passed the National Defense Authorization Act (S.2943) with language that substantially expands coverage for medical foods in the TRICARE program. The bill will now move to the Senate for consideration next week.

Medical foods are medically necessary nutrition that are 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. Patients often cannot eat regular foods found in grocery stores as those affected are often either missing enzymes needed to break down proteins, or are unable to digest certain components of normal foods.  Without access to medical foods, patients can face failure to thrive, health complications, surgery, hospitalization, and early death.

Unfortunately medical foods are almost uniformly 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. The Senate is expected to vote on the bill next week and send the bill to the President for his signature. If enacted, TRICARE, a 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.  Over the past year, NORD has joined forces with patient groups, physician groups, and pediatric gastroenterologists to meet with the Armed Services Committee to advocate on behalf of TRICARE enrollees and families who rely on medical foods for the treatment and management of their rare diseases.

We hope with this momentum we will be able to expand coverage for medical foods in Medicare and Medicaid, as well as other public and private insurers.

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.

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