ACLM Advocacy Update

By Jean Tips, ACLM Senior Director of Communications & Public Affairs

Cartoon drawing of a hand holding a megaphone and 3 characters shouting into it.

The first quarter of 2024 saw a continuation of the historic level of chaos in Congress, particularly in the House of Representatives. Fiscal year 2024 funding, which expired on September 30, 2023, was finally completed nearly six months later on March 22, 2024 after a series of short-term funding “Continuing Resolutions” (CRs). Congress can now fully turn its attention to the business of 2024, although handicapped by the overhang of a presidential election which typically makes passing major legislation difficult. That being said, a long list of health care payment provisions expiring at the end of the calendar year leaves open the possibility for a very active “lame duck” session in December.

Heading into the second quarter, ACLM is aligning its efforts to:

Support relevant existing bills that may now proceed through the passage effort
Prepare for a stakeholder process in the Senate Finance Committee on treatment of chronic disease expected to lead to a Chronic Act 2.0, with the original version having been enacted in 2018
Prepare to comment on an expected Request for Information (RFI) regarding policies aimed at Medicare Part B – physician payment – reform and advocate for those policies
Target Congressional members of key healthcare committees of jurisdiction for outreach
Monitor opportunities for ACLM member participation in such things as ARPA-H HEROES, CMMI pilots, and the new CMS ACO Primary Care Flex payment model

Meanwhile, during this unusual time, ACLM is continuing its work laid out in last fall’s blog article, “ACLM Advocacy Priorities in Support of its Members and Lifestyle Medicine,” and a December 14 email to members.

A Seat at the Table

“Food is medicine” remains a popular convening theme since the Fall 2022 White House Conference on Hunger, Nutrition and Health. The U.S. Department of Health and Human Services (HHS) hosted its first-ever Food is Medicine Summit in Washington, D.C. on Jan. 31st for stakeholders at the intersection of food and health. President Beth Frates, MD, DipABLM, FACLM, and Michelle Tollefson, MD, DipABLM, FACLM, represented ACLM and Jennifer Trilk, PhD, FACSM, DipACLM, represented ACLM and LMEd. To view the recordings of the event, click here.
ACLM Board Member Neha Pathak, MD, FACP, DipABLM, has been selected to serve on the Expert Committee for the National Academy of Medicine’s Communicating About Climate & Health Project. ACLM nominated Neha for this role, an ideal extension of her chairing ACLM’s Global Sustainability Committee.
ACLM was invited by the Academy of Nutrition and Dietetics to join its Primary Care Provider Advisory Board. ACLM current and past board members, Melissa Bernstein, PhD, RD, FAND, DipACLM, and Brenda Rea, MD, RD, PT, DrPh, FACLM, FAAFP, DipABLM, will be serving as ACLM’s representatives.
John McHugh, MD, FACOG, DipABLM, FACLM, was selected to be among the 29 healthcare leaders named to the National Quality Forum’s 2024-2025 Leadership Consortium, a group of experts representing NQF member organizations from the public and private sectors across all aspects of healthcare.
ACLM’s past president, Cate Collings, MD, DipABLM, FACLM, represented ACLM at the AMA State Advocacy Summit Jan. 11-13.
Washington, D.C. diplomate members Drs. Terri Stone, Alka Gupta and Brad Moore attended an event March 6 for the Chief of Staff to HHS Secretary Xavier Beccera, Sean McCluskie. The event included a discussion of issues impacting providers, payers, patients, etc., including the role of lifestyle medicine in medical education.

Letters of Support

ACLM signed on to numerous letters originated by partner and friend organizations on topics of:

Opposition of impending cuts to non-defense (NDD) programs (by the Coalition for Health Funding)
Opposition of proposed percentage cuts to Medicare physician payment (by the AMA)
Support of the Medically Tailored Home-Delivered Meals Demonstration Pilot Act (by the Food is Medicine Coalition)
Support of a New York bill allowing students to access plant-based meal options (by the Physicians Committee for Responsible Medicine)
Adding a water icon to the MyPlate nutritional dietary plate graphic (by the International Bottled Water Association)
Support of prioritizing human health in farm policy discussions (by the Medical Society Consortium on Climate and Health)

White House Commitment Update

As of today, 39,910 people have registered for our complimentary 5.5-hour CME/CE course, “Lifestyle Medicine and Food as Medicine Essentials,” valued at $220 each. We continue to promote it broadly as our commitment in support of the National Strategy on Hunger, Nutrition and Health. We expanded our initial commitment to provide the free course from 100,000 to 200,000 clinicians and extended the deadline to 2025.
We also have determined the first cohort of recipients for the second part of our original commitment, the National Training Initiative (NTI), which provides a matching scholarship for lifestyle medicine training and certification to one primary care provider in each of the nation’s 1,400 FQHCs. The next cohort will be named in June. Thank you to our impact partners whose generous support makes these scholarships possible.
The White House also has just announced a new round of commitments to its strategy resulting from the recent White House Challenge to End Hunger and Build Healthy Communities. Also note the list of other commitments in addition to those highlighted in the release.

Potential Legislation

Last year, ACLM had gathered signatures from more than 16 associations and organizations on its letter to Congressional leaders applauding the Senate Health, Education, Labor, and Pensions (HELP) Committee for its language included in the Bipartisan Primary Care and Work Force Act (S. 2840) requiring that government agencies develop a five-year strategic plan to improve health outcomes through nutrition for low-income or uninsured patient populations with severe, complex chronic conditions and one or more diet-related conditions. While we had advocated for inclusion of this language in any “year-end” vehicle advancing spending, it was not included. However, we learned this may be introduced as a stand-alone bill in the coming months.

Federal Bills We’re Watching

H.R. 6407/S.3297: Medical Nutrition Therapy Act of 2023 (Introduced 11/14/2023)

Summary: The Medical Nutrition Therapy Act of 2023 will provide Medicare beneficiaries with greater access to registered dietitian nutritionists (RDNs) by expanding the availability of nutrition services under Medicare Part B. This expansion would include coverage for the following diseases: diabetes and prediabetes; renal disease; obesity; hypertension; dyslipidemia; malnutrition; eating disorders; cancer; gastrointestinal diseases, including celiac disease; HIV and AIDS; cardiovascular disease; and any other disease or condition specified by the Secretary related to unintentional weight loss. Furthermore, the Medical Nutrition Therapy Act will authorize nurse practitioners, physician assistants, clinical nurse specialists, and psychologists to refer their patients for medical nutrition therapy.

S. 2840: Bipartisan Primary Care and Health Workforce Act (Introduced 9/19/2023)

Summary: This bill provides over $26 billion to expand primary care and address the health care workforce shortage. Specifically, this bill:

Provides mandatory funding over the next 3 years for community health centers and school-based services;
Requires health centers to provide nutrition services;
Provides capital funding primarily to enable community health centers to expand dental care and mental health care in their facilities;
Increases funding for the National Health Service Corps over the next three years;
Provides funding over the next five years in the Teaching Health Center Graduate Medical Education program;
Provides community colleges and state universities with grants to increase the number of students enrolled in accredited, two-year registered nursing programs; and
Provides funding to produce an additional 2,000 primary care doctors by 2032.
S. 2133/H.R.6780: The Medically Tailored Home-Delivered Meals Demonstration Act is now both bicameral and bipartisan. It’s terrific to see this important advancement of a food is medicine proposal in traditional Medicare.

Summary: This bill would establish a Medically Tailored Home-Delivered Meals Demonstration Program to test a payment and service delivery model under part A of Medicare to improve clinical health outcomes and reduce the rate of readmissions of certain individuals. No House companion has yet been introduced, but a similar bill on the House side was introduced in the prior Congress and could be introduced again this Congress.

Health Equity

ACLM Board of Directors member and HEAL Initiative co-chair David Bowman, MD, DipABLM, presented at The Plantrician Project’s inaugural HELP (Health Equity Lifestyle Project) Conference in Huntsville, AL, March 25-27. The conference was attended by medical professionals, leaders of community-based organizations, and local policy leaders who came together to learn about lifestyle medicine’s role in addressing health disparities in historically medically underserved communities.
ACLM partner the Root Cause Coalition has developed an Equity Legislation Monitor (ELM) for the 118th Congress to identify priority issues affecting health disparities and relevant legislation that address them. The ELM provides updates and pertinent information on research, news, and legislation in eight areas: digital equity, environment and climate change; gun violence prevention; housing; maternal health; nutrition and food security; rural health; and payment models.

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