Legislation is pending in the U.S. Congress that will require all public health insurance programs — Medicaid, Children's Health Insurance Program, Medicare, and Federal Employees Health Benefits Program — to cover specialized foods and formulas for certain gastrointestinal and metabolic diseases and disorders.

Take action now by asking congressional lawmakers to cosponsor the bipartisan “Medical Foods and Formulas Act” 

Strong bipartisan cosponsorship of the legislation will be necessary for its advancement in Congress and why your advocacy is needed. 

Patients with gastrointestinal and metabolic diseases and disorders frequently require specialized foods and formulas as their prescribed treatment, yet insurers routinely deny coverage, or will only approve coverage with unreasonable stipulations.

Congress can improve access to medical foods and formulas by passing the “Medical Foods and Formulas Act” 

You can help lawmakers understand the importance of this legislation. Sending an email to your members of Congress takes only a few minutes. A template letter is available that can be personalized.  Share how denials of medical foods and formulas affect the lives and health of patients.
 

Diseases and conditions covered in the legislation include:

Inherited metabolic disorders, including the following:

• Conditions included on the Recommended Uniform Screening Panel Conditions list of the Department of Health and Human Services
• Organic acid conditions
• Fatty acid oxidation disorders
• Amino acid disorders
• Urea cycle disorders
• Glycogen storage disorders
• Biotinidase deficiency
• Guanidinoacetate methyltransferase deficiency
• Inherited disorders of mitochondrial functioning

Medical and surgical conditions of malabsorption, including the following:

• Impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, and motility of the gastrointestinal tract, including short bowel syndrome and chronic intestinal pseudo-obstruction
• Malabsorption due to liver or pancreatic disease

Immunoglobulin E and non-Immunoglobulin E-mediated allergies to food proteins, including the following:

• Immunoglobulin E and non-Immunoglobulin E-mediated allergies to food proteins
• Food protein-induced enterocolitis syndrome
• Eosinophilic disorders, including eosinophilic esophagitis, eosinophilic gastroenteritis, eosinophilic colitis, and post-transplant eosinophilic disorders

Inflammatory or immune mediated conditions of the alimentary tract, including the following:

• Inflammatory bowel disease, including Crohn’s disease, ulcerative colitis, and indeterminate colitis
• Gastroesophageal reflux disease that is nonresponsive to standard medical therapies

Any other disease or condition determined appropriate by the Secretary, in consultation with appropriate scientific entities