Which statement accurately describes Medicare eligibility for home enteral nutrition?

• A. Eligibility is based solely on whether the patient can swallow safely.
• B. Eligibility requires permanent non-function or disease of the structures that normally permit food to reach the small intestine or disease of the small bowel that impairs digestion and absorption, and requires tube feeding to provide enough nutrients to maintain weight and strength; the condition can be anatomic or due to a motility disorder.
• C. Eligibility is limited to patients with cancer.
• D. Eligibility requires the patient to be over 65 years old.

Answer: (B)

Medicare eligibility for home enteral nutrition is based on a permanent impairment of the structures that normally allow food to reach the small intestine, or disease of the small bowel that impairs digestion and absorption, such that tube feeding is needed to provide enough nutrients to maintain weight and strength. The condition can be anatomical or due to a motility disorder, and ongoing medical necessity is required. This isn't determined by age or cancer status, and it's not based solely on whether a patient can swallow safely.