Securing public and private health insurance coverage of Medical Nutrition Therapy (MNT) for celiac disease patients has been a long-time priority of the Celiac Disease Foundation. I am pleased to share with you that we are beginning to see real progress towards our goal.
MNT is defined by federal statute as “nutritional diagnostic, therapy, and counseling services for the purpose of disease management which are furnished by a registered dietitian or nutrition professional … pursuant to a referral by a physician…”. As we know, the only current treatment for celiac disease is strict adherence to a gluten-free diet. Our patient and caregiver community has detailed how difficult it can be to adopt and follow a gluten-free diet in a food ecosystem that includes gluten in more than 80% of its products. Beyond difficulty with adherence, patients must also be mindful to maintain a healthy, balanced diet while excluding gluten. Counseling from a registered dietician or other nutrition professional is essential for the well-being of our community.
However, Medicare coverage of MNT is restricted by federal statute to diabetes and renal disease patients. In 2018, Medicare and Medicaid together insured almost 40% of all Americans. It makes sense, therefore, that private health insurers often take their cues on what therapies to cover or not to cover from the federal government’s health insurance plans. Indeed, in UnitedHealthcare’s MNT Policy Guideline issued in January 2020 about MNT, it states explicitly “UnitedHealthcare follows Medicare guidelines… for the purposes of determining coverage.” As part of our advocacy efforts in Washington DC, therefore, we have fought to get the MNT statute expanded to include celiac disease patients. I am happy to report that in the last several months, bipartisan bills H.R.6971 and S.4504 have been introduced to expand Medicare coverage of MNT for a number of currently uncovered diseases and conditions, including celiac disease. We are encouraging everyone in our community to visit our Take Action Center on celiac.org and ask your Members of Congress to cosponsor these important pieces of legislation.
Should we secure public and private insurance coverage of MNT (and with your help we expect to succeed), we need to ensure that there are sufficient numbers of qualified nutrition professionals to meet the demand. Funded in part by a grant from the Celiac Disease Foundation, the Academy of Nutrition and Dietetics has released a new Certificate of Training (COT) in Treating Gluten-Related Disorders that sets the standard of knowledge for any dietitian treating people with celiac disease. And, with the support of Proud Sponsor Schär, we are offering grants to pay for the COT for dietitians who complete it.
We are working on multiple fronts to expand MNT coverage to all insured Americans with celiac disease and to train a larger cohort of dietitians qualified to treat celiac disease patients. This is the kind of work your philanthropy supports.
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Wishing you good health and safety,
Marilyn G. Geller