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A 7365

Relates to medical assistance coverage for medically tailored meals

2025 Regular Session Introduced by Tony Simone

Expands Medicaid coverage to include medically tailored meals prescribed by clinicians as part of a patient’s treatment plan.

REFERRED TO HEALTH
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WeVote Research Nonpartisan
Bill Summary · A 7365

Summary: Bill A 7365 — Relates to medical assistance coverage for medically tailored meals

Overview

  • Introduced: March 25, 2025
  • Status: REFERRED TO HEALTH
  • Primary sponsor: Tony Simone
  • Related actions: Both dated 2025-03-25 (REFERRED TO HEALTH)
  • Related/companion and prior-session bills: S 1912 (companion); A 9863, A 2794, A 195, A 7244 (prior-session)

Purpose and intent

A 7365 would address medical assistance (Medicaid) coverage for medically tailored meals (MTMs). The bill’s objective is to expand access to MTMs as a covered benefit under medical assistance, recognizing MTMs as therapeutic nutrition prescribed to address specific health conditions. The underlying aim is to support treatment plans, potentially improve health outcomes, and reduce complications or avoidable hospitalizations when MTMs are medically necessary.

What the bill would do (key provisions)

  • Authorize coverage: Allow medical assistance programs to cover medically tailored meals when prescribed or ordered by a qualified clinician as part of a patient’s treatment plan.
  • Definitions: Establish or reference definitions for “medically tailored meals” and related terms to guide eligibility and billing.
  • Eligibility and medical necessity: Set criteria for when MTMs qualify for coverage, typically tied to a diagnosed condition where MTMs are clinically indicated (often conditions where diet plays a central role, such as diabetes, cardiovascular disease, kidney disease, etc.).
  • Provider requirements: Specify who can supply MTMs under the program (e.g., licensed providers, MTM vendors, or approved vendors) and any related credentialing or oversight.
  • Reimbursement and rates: Outline how MTMs would be reimbursed under medical assistance (pricing, submission, audits, and possible cost-sharing parameters).
  • Administration and oversight: Include program administration details—such as enrollment processes, reporting requirements, and compliance measures to ensure program integrity.
  • Interaction with existing benefits: Clarify how MTMs integrate with current medical assistance benefits, including coordination with other nutrition or social supports.

Who is affected

  • Medicaid/medical assistance beneficiaries who require MTMs as part of their medical care.
  • Healthcare providers and clinicians prescribing MTMs.
  • MTM vendors and nutrition service providers authorized to furnish MTMs.
  • State Medicaid program administration, with potential budgeting and administrative implementational needs.

Timing and implementation

  • The bill would designate an effective date and any phase-in period if enacted, with implementation subject to negotiations, rulemaking, and potential federal approval considerations. Specific dates would be set in the enacted text.

Legislative context

  • With companion bills in the Senate (S 1912) and several related bills from prior sessions (A 9863, A 2794, A 195, A 7244), A 7365 reflects ongoing legislative interest in expanding MTM coverage within medical assistance programs.

Potential impact and considerations

  • Health impact: Potentially improved disease management and reduced acute care needs for beneficiaries eligible for MTMs.
  • Economic considerations: Possible changes to state Medicaid costs; requires analysis of fiscal impact and federal match implications.
  • Implementation: Success depends on clear definitions, provider enrollment, provider capacity, and robust program integrity measures.

If you’d like, I can tailor this summary to emphasize potential fiscal impact or to compare A 7365 with the related companion bill S 1912 once text becomes available.

Compiled from official sources — confirm details with the bill’s official record.

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