[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3373 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 3373

To catalyze change in the care and treatment of diabetes in the United 
                                States.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 3, 2007

 Mr. Space (for himself, Ms. DeGette, Mr. Gene Green of Texas, and Mr. 
   Castle) introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To catalyze change in the care and treatment of diabetes in the United 
                                States.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Catalyst to Better 
Diabetes Care Act of 2007''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents; findings.
Sec. 2. Medicare diabetes screening collaboration and outreach program.
Sec. 3. Advisory group regarding diabetes and chronic employee wellness 
                            incentivization and disease management best 
                            practices.
Sec. 4. National diabetes report card.
Sec. 5. Improvement of diabetes mortality data collection.
Sec. 6. Study on appropriate level of diabetes medical education.
    (c) Findings.--The Congress finds as follows:
            (1) Diabetes is a chronic public health problem in the 
        United States that is getting worse.
            (2) According to the Centers for Disease Control and 
        Prevention:
                    (A) One in three Americans born in 2005 will get 
                diabetes.
                    (B) One in two American minorities born in 2005 
                will get diabetes.
                    (C) 1,500,000 new cases of diabetes were diagnosed 
                in adults in 2005.
                    (D) In 2005, 20,800,000 Americans had diabetes, 
                which is 7 percent of the population of the United 
                States.
                    (E) 6,200,000 Americans are currently undiagnosed.
                    (F) About one in every 500 children and adolescents 
                have type 1 diabetes.
                    (G) African-Americans are nearly twice as likely as 
                whites to have diabetes.
                    (H) Nearly 13 percent of American Indians and 
                Alaska Natives over 20 years old have diagnosed 
                diabetes.
                    (I) In States with significant Asian populations, 
                Asians were 1.5 to 2 times as likely as whites to have 
                diagnosed diabetes.
            (3) Diabetes carries staggering costs:
                    (A) In 2002, the total amount of the direct and 
                indirect costs of diabetes was estimated at 
                $132,000,000,000 according to the American Diabetes 
                Association.
                    (B) 18 percent of the Medicare population has 
                diabetes but spending on this group of people consumes 
                32 percent of the Medicare budget according to the 
                Center for Medicare & Medicaid Services.
            (4) Diabetes is deadly. According to the Centers for 
        Disease Control and Prevention:
                    (A) In 2002, according to death certificate 
                reports, diabetes contributed to an official number of 
                224,092 deaths.
                    (B) Diabetes is likely to be seriously 
                underreported as studies have found that only 35 
                percent to 40 percent of decedents with diabetes had it 
                listed anywhere on the death certificate and only about 
                10 percent to 15 percent had it listed as the 
                underlying cause of death.
            (5) Diabetes complications carry staggering economic and 
        human costs for our country and health system:
                    (A) According to death certificate reports, 
                diabetes contributes to over 224,000 deaths a year, 
                although this number is likely vastly underreported.
                    (B) The risk for stroke is 2 to 4 times higher 
                among people with diabetes.
                    (C) Diabetes is the leading cause of new blindness 
                in America, causing approximately 18,000 new cases of 
                blindness each year.
                    (D) Diabetes is the leading cause of kidney failure 
                in America, accounting for 44 percent of new cases in 
                2002.
                    (E) In 2002, 44,400 Americans with diabetes began 
                treatment for end-stage kidney disease and a total of 
                153,730 were living on chronic dialysis or with a 
                kidney transplant as a result of their diabetes.
                    (F) In 2002, approximately 82,000 amputations were 
                performed on Americans with diabetes.
                    (G) Poorly controlled diabetes before conception 
                and during the first trimester of pregnancy can cause 
                major birth defects in 5 percent to 10 percent of 
                pregnancies and spontaneous abortions in 15 percent to 
                20 percent of pregnancies.
            (6) Diabetes is unique because its complications and 
        tremendous costs are preventable with currently available 
        medical treatment:
                    (A) According to the Agency for Healthcare Research 
                and Quality, appropriate primary care for diabetes 
                complications could have saved the Medicare and 
                Medicaid programs $2,500,000,000 in hospital costs in 
                2001 alone.
                    (B) According to the Diabetes Prevention Project 
                sponsored by the National Institutes of Health, 
                lifestyle interventions such as diet and moderate 
                physical activity for those with prediabetes reduced 
                the development of diabetes by 58 percent; among 
                Americans aged 60 and over, lifestyle interventions 
                reduced diabetes by 71 percent.
                    (C) Research shows detecting and treating diabetic 
                eye disease can reduce the development of severe vision 
                loss by 50 percent to 60 percent.
                    (D) Research shows comprehensive foot care programs 
                can reduce amputation rates by 45 percent to 85 
                percent.
                    (E) Research shows detecting and treating early 
                diabetic kidney disease by lowering blood pressure can 
                reduce the decline in kidney function by 30 percent to 
                70 percent.

SEC. 2. MEDICARE DIABETES SCREENING COLLABORATION AND OUTREACH PROGRAM.

    (a) Establishment.--With respect to diabetes screening tests 
provided for under the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003 (Public Law 108-173) and for the purposes of 
reducing the number of undiagnosed beneficiaries with diabetes or 
prediabetes in the Medicare program, the Secretary of Health and Human 
Services (in this section referred to as the ``Secretary''), in 
collaboration with the Director of the Centers for Disease Control and 
Prevention (in this section referred to as the ``Director)'', shall 
establish an outreach program--
            (1) to identify existing efforts to increase awareness 
        among Medicare beneficiaries and providers of the diabetes 
        screening benefit;
            (2) to maximize economies of scale, cost effectiveness, and 
        resource allocation in increasing utilization of the Medicare 
        diabetes screening program; and
            (3) to build upon ongoing efforts of the private and 
        nonprofit sector.
    (b) Consultation.--In carrying out this section, the Secretary and 
the Director shall consult with--
            (1) various units of the Federal Government, including the 
        Centers for Medicare & Medicaid Services, the Surgeon General 
        of the Public Health Service, the Agency for Health Research 
        and Quality, the Health Resources and Services Administration, 
        and the National Institutes of Health; and
            (2) entities with an interest in diabetes, including 
        industry, voluntary health organization, trade associations, 
        and professional societies.

SEC. 3. ADVISORY GROUP REGARDING DIABETES AND CHRONIC EMPLOYEE WELLNESS 
              INCENTIVIZATION AND DISEASE MANAGEMENT BEST PRACTICES.

    (a) Establishment.--The Secretary of Commerce shall establish an 
advisory group consisting of representatives of the public and private 
sector. The advisory group shall include representatives from the 
Department of Commerce, the Department of Health and Human Services, 
the Small Business Administration, and public and private sector 
entities with experience in administering and operating employee 
wellness and disease management programs.
    (b) Duties.--The advisory group established under subsection (a) 
shall examine and make recommendations of best practices of chronic 
illness employee wellness incentivization and disease management 
programs in order to--
            (1) provide public and private sector entities with 
        improved information in assessing the role of employee wellness 
        incentivization and disease management programs in saving money 
        and improving quality of life for patients with chronic 
        illnesses; and
            (2) encourage the adoption of effective chronic illness 
        employee wellness and disease management programs.
    (c) Report.--Not later than 1 year after the date of the enactment 
of this Act, the advisory group established under subsection (a) shall 
submit to the Secretary of Health and Human Services, the Speaker and 
Minority Leader of the House of Representatives, and the Majority 
Leader and Minority Leader of the Senate, the results of the 
examination under subsection (b)(1).

SEC. 4. NATIONAL DIABETES REPORT CARD.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), in collaboration 
with the Director of the Centers for Disease Control and Prevention 
(referred to in this section as the ``Director''), shall prepare a 
national diabetes report card (referred to in this section as a 
``Report Card'') for the Nation and, to the extent possible, for each 
State on a biennial basis, that includes the statistically valid 
aggregate health outcomes related to individuals diagnosed with 
diabetes including--
            (1) HbA1c level;
            (2) LDL;
            (3) blood pressure; and
            (4) complications and comorbidities.
    (b) Report.--The Secretary, in collaboration with the Director, 
shall--
            (1) submit each Report Card to Congress; and
            (2) make each Report Card readily available in print and 
        electronically to each State and to the public.
    (c) Adaptable.--Each Report Card shall be able to be adapted by 
State and, where possible, local agencies in order to rate or report 
local diabetes care, costs, and prevalence.
    (d) Updated Report.--Each Report Card that is prepared after the 
initial Report Card shall include trend analysis for the Nation, and, 
to the extent possible, for each State, in order to track progress in 
meeting established national goals and objectives for improving 
diabetes care, costs, and prevalence (including Healthy People 2010), 
and to inform policy and program development.

SEC. 5. IMPROVEMENT OF DIABETES MORTALITY DATA COLLECTION.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary''), acting through the 
Director of the Centers for Disease Control and Prevention (in this 
section referred to as the ``Director''), and in collaboration with 
appropriate agencies, shall conduct, support, and promote the 
collection, analysis, and publication of biennial data on the 
prevalence and incidence of type 1 and 2 diabetes and of prediabetes.
    (b) Improvement of Mortality Data Collection.--
            (1) Assessment.--The activities described in subsection (a) 
        shall include an assessment of diabetes as a primary or 
        underlying cause of death and analysis of any under-reporting 
        of diabetes as a primary or underlying cause of death in order 
        to provide an accurate estimate of yearly deaths related to 
        diabetes.
            (2) Death certificate additional language.--In carrying out 
        the activities described in paragraph (1), the Secretary may 
        promote the addition of language to death certificates to 
        improve collection of diabetes mortality data, including adding 
        questions for the individual certifying to the cause of death 
        regarding whether the deceased had diabetes and whether 
        diabetes was an immediate, underlying, or contributing cause of 
        or condition leading to death.
    (c) Report.--
            (1) In general.--The Secretary and the Director shall 
        submit to the Committee on Health, Education, Labor, and 
        Pensions of the Senate and the Committee on Energy and Commerce 
        of the House of Representatives annual reports describing the 
        activities undertaken under this section.
            (2) Content.--The reports shall include an--
                    (A) analysis of any under-reporting of diabetes as 
                a primary or underlying cause of death in order to 
                provide an accurate estimate of yearly deaths related 
                to diabetes; and
                    (B) projections regarding trends in each of the 
                areas described in subparagraph (A).
            (3) Availability.--The Secretary and the Director shall 
        make such reports publicly available in print and on the 
        Internet site of the Centers for Disease Control and 
        Prevention.

SEC. 6. STUDY ON APPROPRIATE LEVEL OF DIABETES MEDICAL EDUCATION.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall, in collaboration 
with the Institute of Medicine and appropriate associations and 
councils, conduct a study of the impact of diabetes on the practice of 
medicine in the United States and the appropriateness of the level of 
diabetes medical education that should be required prior to licensure, 
board certification, and board recertification.
    (b) Report.--Not later than 2 years after the date of the enactment 
of this Act, the Secretary shall submit a report on the study under 
subsection (a) to the Committees on Ways and Means and Energy and 
Commerce of the House of Representatives and the Committees on Finance 
and Health, Education, Labor, and Pensions of the Senate.
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