LCO No. 5125 1 of 4 General Assembly Raised Bill No. 6857 January Session, 2023 LCO No. 5125 Referred to Committee on HUMAN SERVICES Introduced by: (HS) AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE FOOD AS MEDICINE WORKING GROUP. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. (NEW) (Effective from passage) (a) As used in this section and 1 section 2 of this act, (1) "certified dietitian-nutritionist" means a dietitian-2 nutritionist certified pursuant to section 20-206n of the general statutes, 3 (2) "certain health conditions" means conditions including, but not 4 limited to, prediabetes, gestational diabetes and types 1 and 2 diabetes, 5 heart disease, including hypertension, hypercholesterol, dyslipidemia 6 and congestive heart failure, food allergies, celiac disease, chronic 7 obstructive pulmonary disease, renal disease and obesity, (3) "health 8 care provider" means a physician, physician's assistant, advanced 9 practice registered nurse, certified dietitian-nutritionist or certified 10 diabetes educator, and (4) "produce prescription" means a prescription 11 for fruits and vegetables without added salt, sugar or fat given to a 12 Medicaid enrollee with certain health conditions by a health care 13 provider. 14 (b) The Commissioner of Social Services shall apply for a Medicaid 15 Raised Bill No. 6857 LCO No. 5125 2 of 4 waiver under Section 1115 of the Social Security Act for a three-year 16 pilot program to provide Medicaid coverage for produce prescriptions 17 for a Medicaid enrollee with certain health conditions. The 18 commissioner may provide such enrollee with vouchers or an electronic 19 debit card restricted to purchases of prescribed produce. 20 (c) Not later than January 15, 2024, January 15, 2025, and January 15, 21 2026, the commissioner shall file reports, in accordance with the 22 provisions of section 11-4a of the general statutes, with the joint 23 standing committee of the General Assembly having cognizance of 24 matters relating to human services on (1) the number of Medicaid 25 enrollees who have received produce prescriptions, (2) data regarding 26 the effect produce prescriptions have on their health, including, but not 27 limited to, indicators such as blood sugar levels, blood pressure and 28 serum lipids, (3) the effect on ranges of food insecurity, as measured by 29 the United States Department of Agriculture, and (4) the cost to the state 30 to provide Medicaid reimbursement for such prescriptions compared to 31 any savings generated by improved health outcomes for such enrollees. 32 The commissioner shall share aggregate data on food insecurity among 33 pilot program participants with organizations that track data on food 34 insecurity and connect food insecure persons with nutritional 35 assistance. 36 Sec. 2. (Effective from passage) (a) As used in this section, (1) "medically 37 tailored meals" means a meal plan consisting of five to twenty-one meals 38 per week tailored by a certified dietitian-nutritionist, or other qualified 39 nutrition professional as determined by the Commissioner of Social 40 Services, to help treat certain health conditions of Medicaid enrollees, 41 and (2) "medically tailored food" means partially prepared or 42 nonprepared food items, or both, sufficient to prepare not more than 43 fourteen meals per week selected by a certified dietitian-nutritionist, or 44 other qualified nutrition professional as determined by the 45 commissioner, as part of a treatment plan for a Medicaid enrollee with 46 certain health conditions. 47 (b) The Commissioner of Social Services shall convene a working 48 Raised Bill No. 6857 LCO No. 5125 3 of 4 group not later than August 1, 2023, to develop recommendations to 49 improve health outcomes for Medicaid enrollees with certain health 50 conditions by treating food as medicine. The working group's study 51 shall include, but not be limited to, best practices for integrating 52 medically tailored meals and medically tailored food for Medicaid 53 enrollees with certain health conditions into the state's medical 54 assistance program. 55 (c) The working group shall consist of (1) the Commissioner of Social 56 Services, or the commissioner's designee; (2) the Commissioner of 57 Agriculture, or the commissioner's designee; (3) a representative of the 58 elderly nutrition program administered by the Department of Aging 59 and Disability Services, appointed by the Commissioner of Aging and 60 Disability Services; (4) a certified dietitian-nutritionist with experience 61 in planning medically tailored meals or medically tailored foods for 62 persons with certain health conditions, appointed by the Commissioner 63 of Social Services; (5) an academic professional, who has researched the 64 link between nutrition and certain health conditions, appointed by the 65 Commissioner of Social Services; (6) two Medicaid enrollees with 66 certain health conditions, appointed by the Commissioner of Social 67 Services; (7) one person appointed by the House chairperson of the joint 68 standing committee of the General Assembly having cognizance of 69 matters relating to human services; and (8) one person appointed by the 70 Senate chairperson of the joint standing committee of the General 71 Assembly having cognizance of matters relating to human services. 72 (d) The chairpersons of the working group shall be chosen by 73 members of the working group. The working group shall meet not less 74 than monthly and shall provide recommendations to the Commissioner 75 of Social Services not later than January 1, 2024. The working group shall 76 terminate on the date that it submits such report or January 1, 2024, 77 whichever is later. 78 Sec. 3. Section 17b-28e of the general statutes is amended by adding 79 subsection (f) as follows (Effective from passage): 80 Raised Bill No. 6857 LCO No. 5125 4 of 4 (NEW) (f) Not later than October 1, 2023, the Commissioner of Social 81 Services shall amend the Medicaid state plan to add reimbursement for 82 medical nutrition therapy provided by a dietitian-nutritionist certified 83 pursuant to section 20-206n to a Medicaid enrollee with certain health 84 conditions. For purposes of this subsection, "certain health conditions" 85 has the same meaning as provided in section 1 of this act and "medical 86 nutrition therapy" means an evidence-based, individualized nutrition 87 plan designed to help treat certain health conditions. 88 This act shall take effect as follows and shall amend the following sections: Section 1 from passage New section Sec. 2 from passage New section Sec. 3 from passage 17b-28e(f) Statement of Purpose: To establish (1) a pilot program to provide Medicaid funding for produce prescriptions for Medicaid enrollees with certain health conditions, (2) a working group to develop additional recommendations, including for providing medically tailored meals for such persons, and (3) Medicaid reimbursement for certified dietitian- nutritionists who provide medical nutrition therapy. [Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]