H.R. 8390

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8390 Introduced in House (IH)]

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119th CONGRESS
2d Session
H. R. 8390

To provide for the establishment or expansion of Food as Medicine 
programs, and for other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

April 20, 2026

Mr. Ruiz introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee on 
Agriculture, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the 
jurisdiction of the committee concerned

_______________________________________________________________________

A BILL

To provide for the establishment or expansion of Food as Medicine 
programs, and for other purposes.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``National Food as Medicine Program 
Act of 2026''.

SEC. 2. FOOD AS MEDICINE MEDICAID WAIVER GRANT PROGRAM.

(a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall establish a 
program under which the Secretary shall award grants to States to plan, 
implement, expand, or evaluate Food as Medicine programs.
(b) Application.--A State seeking a grant under this section shall 
submit an application to the Secretary at such time, in such manner, 
and containing such information as the Secretary may require.
(c) Priority.--In awarding grants under this section, the Secretary 
shall give priority to States that have, as of the date of submission 
of the application for a grant under this section, a partnership with--
(1) a network of health care providers that includes 
public, nonprofit, and community-based organizations or 
entities, and community health clinics, including Federally 
qualified health centers (as defined in section 1861 of the 
Social Security Act (42 U.S.C. 1395x)); or
(2) public, nonprofit, socially disadvantaged, and 
community-based organizations or entities that provide locally-
sourced (or regionally-sourced, if locally-sourced produce is 
not available) agricultural products (as defined in section 207 
of the Agricultural Marketing Act of 1946 (7 U.S.C. 1626)) 
grown, or working to transition to, a covered method of 
production.
(d) Use of Funds.--A State that receives a grant under this 
section shall use funds received through the grant to establish, 
implement, and expand Food as Medicine interventions to reduce 
nutrition-related chronic conditions, address food and nutrition 
insecurity, and improve health through providing locally-sourced (or 
regionally-sourced, if locally-sourced produce is not available) 
agricultural products grown, or working to transition to, a covered 
method of production.
(e) Report to the Secretary.--Not less than 3 years after the date 
on which a State receives a grant under this section, such State shall 
provide to the Secretary a report that contains--
(1) an evaluation of the impact of the Food as Medicine 
program established or expanded in such State, including 
relevant data collected under the Medicaid program under title 
XIX of the Social Security Act (42 U.S.C. 1396 et seq.);
(2) the impact of the Food as Medicine program on, with 
respect to individuals participating in such program, the 
appropriate health, nutrition, and associated behavioral 
outcome baseline information for such individuals that is 
relevant to the stated goals and desired outcomes of the pilot 
project;
(3) to the extent possible, the Food as Medicine Program's 
impact on hospital admissions and readmissions, admissions into 
long-term care facilities, medication utilization, emergency 
room utilization rates, primary care, specialty care, primary 
care medical home engagement, patient experience, and health 
care team engagement;
(4) other relevant findings, including recommendations on 
strengthening the administration of the program and resources 
needed to support and strengthen the Food as Medicine program.
(f) Definitions.--In this section:
(1) The term ``covered method of production'' means, with 
respect to an agricultural product, that the product is--
(A) regeneratively produced;
(B) organically produced; or
(C) regeneratively and organically produced.
(2) The term ``Food as Medicine program'' means a program 
under which a State pursuant to a waiver under section 1115 of 
the Social Security Act (42 U.S.C. 1315) provides to 
individuals eligible to receive medical assistance under such 
waiver medically supportive food and nutrition interventions.
(3) The term ``food hub'' means a business or organization 
that actively manages the aggregation, distribution, and 
marketing of source-identified food products primarily from 
local and regional producers to strengthen their ability to 
satisfy wholesale, retail, and institutional demand.
(4)(A) The term ``medically supportive food and nutrition 
interventions'' means interventions that provide culturally-
appropriate, nutrient-rich whole food (including any fresh 
vegetables and fruit, legume, nut, seed, whole grain, low-
mercury and high-omega-3 fatty acid seafood, or lean animal 
protein) prescribed by a health care professional for the 
prevention, reversal, or treatment of certain health 
conditions.
(B) Such term includes the following interventions:
(i) Meals that are--
(I) tailored to a recipient's health 
conditions by a registered dietitian 
nutritionist and adhere to standards informed 
by available dietary recommendations for 
specific health conditions or dietary 
therapies. based on evidence-based nutritional 
practice guidelines; and
(II) consistent with the Dietary Guidelines 
for Americans established under section 301 of 
the National Nutrition Monitoring and Related 
Research Act of 1990 (7 U.S.C. 5341).
(ii) Produce (vegetables and fruit) prescriptions, 
delivered or procured from in a grocery store, farm, 
farmers' market, or food hub, that are consistent with 
the Dietary Guidelines for Americans established under 
section 301 of the National Nutrition Monitoring and 
Related Research Act of 1990 (7 U.S.C. 5341).
(iii) Nutrition coaching or counseling, group 
medical visits, cooking education and tools, health 
coaching, and other behavioral supports based on a 
recipient's medical conditions, when paired with the 
interventions described in subparagraphs (A) and (B).
(5) The term ``organically produced'' means, with respect 
to an agricultural product, that the product is--
(A) certified under the Organic Foods Production 
Act of 1990 (7 U.S.C. 6501 et seq.) as organically 
produced; or
(B) verified through a community-based, culturally-
appropriate verification program under the Organic 
Foods Production Act of 1990 as organically produced.
(6) The term ``regeneratively produced'' means, with 
respect to an agricultural product, that the product is 
produced--
(A) using an integrated approach to farming and 
ranching rooted in the principles of soil health 
leading to improved target outcomes, including--
(i) building soil health;
(ii) restoring and maintaining water 
resources;
(iii) protecting air quality;
(iv) sequestering greenhouse gas emissions;
(v) using sustainable and integrated pest 
management to eliminate reliance on pesticides;
(vi) improving nutrient cycling to reduce 
use of external fertilizers;
(vii) supporting Native-led stewardship 
practices (as described in Order No. 3403 
entitled ``Joint Secretarial Order on 
Fulfilling the Trust Responsibility to Indian 
Tribes in the Stewardship of Federal Lands and 
Waters'' published jointly by the Secretary of 
Agriculture and the Secretary of the Interior 
on November 15, 2021); and
(viii) fostering wildlife and animal 
welfare; and
(B) in a manner that fosters community and social 
wellness, including--
(i) improving human health in rural and 
urban communities;
(ii) creating supportive livelihoods 
(worker conditions, safety) and durable 
solutions for a healthy food and agriculture 
workforce;
(iii) creating economic vitality for 
farmers, ranchers, and a healthy food and 
agriculture workforce; and
(iv) optimizing the above target outcomes 
to ensure that there is minimal negative impact 
on other target outcomes.
(7) The term ``regeneratively-organically produced'' means, 
with respect to an agricultural product, that the product is 
produced--
(A) using some organic methods, as described in the 
Organic Foods Production Act of 1990 (7 U.S.C. 6501 et 
seq.); and
(B) using some methods included in the integrated 
approach described in paragraph (5).
(8) The term ``State'' each of the several States and each 
territory and possession of the United States.

SEC. 3. DEPARTMENT OF AGRICULTURE FOOD AS MEDICINE TECHNICAL ASSISTANCE 
PROGRAM.

(a) In General.--The Secretary of Agriculture (referred to in this 
section as the ``Secretary'') shall enter into cooperative agreements 
with eligible entities to provide technical assistance and 
infrastructure support to producers to enable such producers to connect 
with local health care providers for purposes of providing nutritious 
food under a Food is Medicine program established or expanded pursuant 
to section 2. An eligible entity may work in collaboration with a 
Regional Food Business Center of the Department of Agriculture to 
provide such technical assistance under a cooperative agreement.
(b) Application.--An eligible entity seeking to enter into a 
cooperative agreement under this section shall submit to the Secretary 
an application at such time, in such manner, and containing such 
information as the Secretary may require.
(c) Priority.--In selecting eligible entities with which to enter 
into cooperative agreements under this section, the Secretary shall 
give priority to applications containing proposals--
(1) to provide technical assistance and infrastructure 
support to beginning farmers and ranchers (as defined in 
section 343(a) of the Consolidated Farm and Rural Development 
Act (7 U.S.C. 1991(a))) and socially disadvantaged farmers and 
ranchers (as defined in section 355(e) of the Consolidated Farm 
and Rural Development Act (7 U.S.C. 2003(e))); and
(2) to provide technical assistance and infrastructure 
support to producers that produce agricultural products (as 
defined in section 207 of the Agricultural Marketing Act of 
1946 (7 U.S.C. 1626)) that are produced using a covered method 
of production (as defined in section 2) or verified through 
community-based, culturally appropriate verification programs.
(d) Definitions.--In this section:
(1) The term ``Food is Medicine program'' has the meaning 
given such term in section 2.
(2) The term ``eligible entity'' means--
(A) a land-grant college or university;
(B) a food hub (as defined in section 2); or
(C) a Regional Food Business Center supported by 
the Department of Agriculture.
(3) The term ``land-grant college or university'' has the 
meaning given the term ``land-grant colleges and universities'' 
in section 1404 of the National Agricultural Research, 
Extension, and Teaching Policy Act of 1977 (7 U.S.C. 3103).

SEC. 4. REPORT TO CONGRESS.

Not later than one year after the date on which the first grant is 
awarded under section 2, the Secretary of Health and Human Services, in 
consultation with the Secretary of Agriculture, shall submit to 
Congress a report that includes the information received from the 
States under section 2 and the Secretary's recommendations with respect 
to best practices for carrying out a Food is Medicine program.

SEC. 5. FOOD AS MEDICINE GUIDANCE.

(a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Health and Human Services, in 
consultation with the officials and stakeholders described in 
subsection (c), shall develop and issue--
(1) recommendations for States and counties to implement or 
expand a Food as Medicine program (as defined in section 2), 
clinical nutrition training for health care providers, and 
nutritional and behavioral support for patients to integrate 
food interventions into daily habits; and
(2) guidance related to--
(A) how a State may include food insecurity and or 
nutrition insecurity as conditions making an individual 
eligible to participate in Food as Medicine programs, 
in addition to eligible populations with chronic 
conditions;
(B) eligible populations that address food 
insecurity, nutrition insecurity, and chronic 
conditions;
(C) the duration and dosage of medically supportive 
food and nutrition intervention plans;
(D) the value-based procurement of food through a 
managed care rate setting process that includes minimum 
percentages and tier-based incentives to increase the 
procurement of products grown using covered methods of 
production (as defined in section 2) by socially 
disadvantaged farmers and ranchers (as defined in 
section 2501 of the Food, Agriculture, Conservation, 
and Trade Act of 1990 (7 U.S.C. 2279));
(E) determination of providers permitted to provide 
medically supportive food and nutrition interventions 
(as defined in section 2); and
(F) continuing education for health care providers 
prescribing medically supportive food and nutrition 
interventions.
(b) Public Comment Period.--The Secretary shall provide for 30-day 
public comment period with respect to any proposed guidance issued 
under this section. Such guidance shall not be finalized until the date 
that is 60 days after the close of such public comment period.
(c) Officials and Stakeholders Described.--The officials and 
stakeholders described in this subsection include the following:
(1) The heads of appropriate Federal agencies within the 
Department of Health and Human Services.
(2) The Secretary of Agriculture.
(3) Diverse stakeholders from community-based 
organizations, small- to medium-sized farms operated by 
socially disadvantaged farmers and ranchers, food hubs, health 
care providers, and Medicaid managed care organizations who 
have helped to implement Food as Medicine programs.
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