[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3544 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 3544

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


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 17, 2007

   Mr. Space (for himself, Ms. DeGette, Mr. Gene Green of Texas, Mr. 
Castle, Mr. Cohen, and Mr. Honda) 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 illness employee 
                            wellness incentivization and disease 
                            management best practices.
Sec. 4. National Diabetes Report Card.
Sec. 5. Improvement of vital statistics 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 2000 will get 
                diabetes.
                    (B) One in two Hispanic females born in 2000 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 many of its complications 
        and tremendous costs are largely preventable through early 
        detection, better education on diabetes self-management, and 
        improved delivery of 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--
            (1) review uptake and utilization of the diabetes screening 
        benefit to identify and address any existing problems with 
        regard to utilization and data collection mechanisms to 
        accurately track uptake;
            (2) establish an outreach program to identify existing 
        efforts by agencies and by the private and nonprofit sectors to 
        increase awareness among Medicare beneficiaries and providers 
        of the diabetes screening benefit; and
            (3) maximize economies of scale, cost effectiveness, and 
        resource allocation in increasing utilization of the diabetes 
        screening benefit.
    (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 Healthcare 
        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 organizations, trade associations, 
        and professional societies.

SEC. 3. ADVISORY GROUP REGARDING DIABETES AND CHRONIC ILLNESS 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 on a 
biennial basis 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.
    (b) Contents.--
            (1) In general.--Each Report Card shall include 
        statistically valid aggregate health outcomes related to 
        individuals diagnosed with diabetes and prediabetes including--
                    (A) preventative care practices and quality of 
                care;
                    (B) risk factors; and
                    (C) outcomes.
            (2) Updated reports.--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, for the 
        purpose of--
                    (A) tracking progress in meeting established 
                national goals and objectives for improving diabetes 
                care, costs, and prevalence (including Healthy People 
                2010); and
                    (B) informing policy and program development.
    (c) Availability.--The Secretary, in collaboration with the 
Director, shall make each Report Card publicly available, including by 
posting the Report Card on the Internet.

SEC. 5. IMPROVEMENT OF VITAL STATISTICS COLLECTION.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), acting through the 
Director of the Centers for Disease Control and Prevention and in 
collaboration with appropriate agencies and States, shall--
            (1) promote the education and training of physicians on the 
        importance of birth and death certificate data and how to 
        properly complete these documents, including the collection of 
        such data for diabetes and other chronic diseases;
            (2) encourage State adoption of the latest standard 
        revisions of birth and death certificates; and
            (3) work with States to re-engineer their vital statistics 
        systems in order to provide cost-effective, timely, and 
        accurate vital systems data.
    (b) Death Certificate Additional Language.--In carrying out this 
section, the Secretary may promote the addition of language to death 
certificates to improve collection of diabetes mortality data, 
including the addition of a question for the individual certifying to 
the cause of death regarding whether the deceased had diabetes.

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.
                                 <all>