Access to Quality Diabetes Education Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to recognize state-licensed or -registered certified diabetes educators or state-licensed or -registered health care professionals who specialize in teaching individuals with diabetes to develop the necessary skills and knowledge to manage the individual's diabetic condition and are certified as a diabetes educator by a recognized certifying body.
Directs the Comptroller General (GAO) to study the barriers that exist for Medicare beneficiaries with diabetes in accessing diabetes self-management training services under the Medicare program.
Requires the Director of the Agency for Health Care Research and Quality of the Department of Health and Human Services (HHS) to develop a series of recommendations on effective outreach methods to educate primary care physicians and other health care providers as well as the public about the benefits of diabetes self-management training.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1274 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 1274
To amend title XVIII of the Social Security Act to improve access to
diabetes self-management training by authorizing certified diabetes
educators to provide diabetes self-management training services,
including as part of telehealth services, under part B of the Medicare
program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 19, 2013
Mr. Whitfield (for himself and Ms. DeGette) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and
in addition to the Committee on Ways and Means, 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 amend title XVIII of the Social Security Act to improve access to
diabetes self-management training by authorizing certified diabetes
educators to provide diabetes self-management training services,
including as part of telehealth services, under part B of the Medicare
program.
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 ``Access to Quality Diabetes Education
Act of 2013''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) The Centers for Disease Control and Prevention
(hereinafter ``CDC'') report that nearly 26,000,000 Americans
have diabetes, in addition to an estimated 79,000,000 Americans
who have prediabetes, an increase of 24,000,000 Americans with
either diabetes or prediabetes since 2008. People with
prediabetes are at increased risk of developing Type 2 diabetes
or cardiovascular disease.
(2) Diabetes impacts 8.3 percent of all Americans and 11.3
percent of American adults. The CDC estimates that as many as 1
in 3 Americans will have diabetes by 2050 if current trends
continue.
(3) According to the American Diabetes Association, the
total costs of diagnosed diabetes have risen to $245 billion in
2012 from $174 billion in 2007, when the cost was last examined
by the CDC. This figure represents a 41 percent increase over a
five-year period.
(4) One in 3 Medicare dollars is currently spent on people
with diabetes.
(5) There were 11.3 million diabetes related emergency room
visits in 2008, compared with 9.5 million in 2000, an increase
of 11 percent.
(6) According to the CDC, health care providers are finding
statistically significant increases in the prevalence of Type 2
diabetes in children and adolescents.
(7) Diabetes self-management training (hereinafter
``DSMT''), also called diabetes education, provides critical
knowledge and skills training to patients with diabetes,
helping them manage medications, address nutritional issues,
facilitate diabetes-related problem solving, and make other
critical lifestyle changes to effectively manage their
diabetes. Evidence shows that individuals participating in DSMT
programs are able to progress along the continuum necessary to
make sustained behavioral changes in order to manage their
diabetes.
(8) A certified diabetes educator is a State licensed or
registered health care professional who specializes in helping
people with diabetes develop the self-management skills needed
to stay healthy and avoid costly acute complications and
emergency care, as well as debilitating secondary conditions
caused by diabetes.
(9) Diabetes self-management training has been proven
effective in helping to reduce the risks and complications of
diabetes and is a vital component of an overall diabetes
treatment regimen. Patients who have received training from a
certified diabetes educator are better able to implement the
treatment plan received from a physician skilled in diabetes
treatment.
(10) Lifestyle changes, such as those taught by certified
diabetes educators, directly contribute to better glycemic
control and reduced complications from diabetes. Evidence shows
that the potential for prevention of the most serious medical
complications caused by diabetes to be as high as 90 percent
(blindness), 85 percent (amputations), and 50 percent (heart
disease and stroke) with proper medical treatment and active
self-management.
(11) In recognition of the important role of DSMT programs,
the CDC in 2012 awarded funding to expand the National Diabetes
Prevention Program to help prevent the onset of Type 2 diabetes
for individuals at high risk.
(12) The net savings to the Medicare program of ensuring
that beneficiaries have access to quality DSMT is estimated to
be $2,000,000,000 over 10 years.
(13) Despite its effectiveness in reducing diabetes-related
complications and associated costs, diabetes self-management
training has been recognized by the Centers for Medicare &
Medicaid Services as an underutilized Medicare benefit, even
after more than a decade of coverage.
(14) Enhancing access to diabetes self-management training
programs that are certified as necessary by the patient's
treating physician and taught by certified diabetes educators
is an important public policy goal that can help improve health
outcomes, ensure quality, and reduce escalating diabetes-
related health costs.
SEC. 3. RECOGNITION OF CERTIFIED DIABETES EDUCATORS AS AUTHORIZED
PROVIDERS OF MEDICARE DIABETES OUTPATIENT SELF-MANAGEMENT
TRAINING SERVICES.
(a) In General.--Section 1861(qq) of the Social Security Act (42
U.S.C. 1395x(qq)) is amended--
(1) in paragraph (1), by striking ``by a certified provider
(as described in paragraph (2)(A)) in an outpatient setting''
and inserting ``in an outpatient setting by a certified
diabetes educator (as defined in paragraph (3)) or by a
certified provider (as described in paragraph (2)(A))''; and
(2) by adding at the end the following new paragraphs:
``(3) For purposes of paragraph (1), the term `certified diabetes
educator' means an individual--
``(A) who is licensed or registered by the State in which
the services are performed as a certified diabetes educator; or
``(B) who--
``(i) is licensed or registered by the State in
which the services are performed as a health care
professional;
``(ii) specializes in teaching individuals with
diabetes to develop the necessary skills and knowledge
to manage the individual's diabetic condition; and
``(iii) is certified as a diabetes educator by a
recognized certifying body (as defined in paragraph
(4)).
``(4) For purposes of paragraph (3)(B)(iii), the term `recognized
certifying body' means a certifying body for diabetes educators which
is recognized by the Secretary as authorized to grant certification of
diabetes educators for purposes of this subsection pursuant to
standards established by the Secretary.''.
(b) Treatment as a Practitioner, Including for Telehealth
Services.--Section 1842(b)(18)(C) of the such Act (42 U.S.C.
1395u(b)(18)(C)) is amended by adding at the end the following new
clause:
``(vii) A certified diabetes educator (as defined in
section 1861(qq)(3)).''.
(c) GAO Study and Report.--
(1) Study.--The Comptroller General of the United States
shall conduct a study to identify the barriers that exist for
Medicare beneficiaries with diabetes in accessing diabetes
self-management training services under the Medicare program,
including economic and geographic barriers and availability of
appropriate referrals and access to adequate and qualified
providers.
(2) Report.--Not later than 1 year after the date of the
enactment of this Act, the Comptroller General of the United
States shall submit to Congress a report on the study conducted
under paragraph (1).
(d) AHRQ Development of Recommendations for Outreach Methods and
Report.--
(1) Development of recommendations.--The Director of the
Agency for Healthcare Research and Quality shall, through use
of a workshop and other appropriate means, develop a series of
recommendations on effective outreach methods to educate
physicians and other health care providers as well as the
public about the benefits of diabetes self-management training
in order to promote better health outcomes for patients with
diabetes.
(2) Report.--Not later than 1 year after the date of the
enactment of this Act, the Director of the Agency for
Healthcare Research and Quality shall submit to Congress a
report on the recommendations developed under paragraph (1).
(e) Effective Date.--The amendments made by this section shall
apply to items and services furnished after the end of the 12-month
period beginning on the date of the enactment of this Act.
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Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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