A new Senate bill introduced last week by Sen. Jeff Merkley (D-OR) called the “Older Americans CARE Act” provides funding for programs that support the elderly. The bill states that those services can be provided by “a nurse, registered dietitian, case manager, health coach, or social worker.” As introduced, “nutritionist” is not included in that list. However, after being made aware of the oversight, Sen. Merkley’s office has vowed to add nutritionists when the bill is reintroduced next year.
Under the current bill, only registered dietitians would be eligible to provide medical nutrition therapy (MNT) to patients for the management of chronic disease. Any federal legislation/program that creates a monopoly for dietitians, especially in connection to MNT, should not be supported and ANH quickly put out an action alert calling attention to the issue.
We would like to thank Sen. Merkley and his staff for their timely response to our concerns and understanding of the issue.
Registered dietitians continue to try to carve out unique privileges for themselves, as we saw when we lobbied to amend the Treat and Reduce Obesity Act. We found that particularly galling because the dietetics lobby receives funding from junk food companies like Coca-Cola, Hershey, Council, Mars, and PepsiCo—the very agents of the obesity epidemic. Furthermore, they have conducted continuing education courses sponsored by Coke in which RDs are told that sugar, artificial colors, and nonnutritive sweeteners are perfectly fine for children, and concerns to the contrary are merely “urban myths”!
Any legislation on the state or federal level that excludes nutritionists is at odds with other federal laws. As the Board for Certification of Nutrition Specialists said in a letter to Sen. Merkley:
- Medicare recognizes “other nutrition professionals” as providers of MNT.
- “Other nutrition professionals” are recognized in the Affordable Care Act, and are recognized by a growing number of states.
- The Centers for Medicare and Medicaid (CMS) ruled in May of this year that qualified nutrition professionals be recognized as equal to registered dietitians in eligibility for hospital staff appointments, and for prescriptive diet authority in hospitals (in accordance with hospital policy and state law).
As you may remember, ANH-USA alerted you to the sneaky insertion by the dietetic lobby into draft CMS rules that hospital diets could be ordered by registered dietitians (RDs)— but not by other highly qualified nutrition professionals. Thanks to your messages and our official comments to CMS, the final rule was changed to recognize equally or often more qualified nutrition professionals alongside RDs.
Nutrition professionals are right to demand equal and fair treatment in all legislation, and we thank Sen. Merkley’s office for their efforts to understand the issue and commitment to make changes to the Older Americans CARE Act.
*Editor’s Note: This article has been updated since its first appearance on 9/2/14. ANH-USA commends the efforts of Sen. Merkley’s office to correct their initial oversight. The corresponding Action Alert has been taken down, but we remain vigilant to protect the role of nutritionists in today’s health care system.