1.This Act may be cited as
the Diabetes Screening and Medicaid
Savings Act of 2007
.
2.Improvement of
diabetes screening and treatment under medicaid
(a)Diabetes
screening tests for adult enrollees with diabetes risk
factorsSection 1905(a)(4) of the Social Security Act (42 U.S.C.
1396d(a)(4)) is amended—
(1)in subsection
(a)(4)—
(A)by striking
and
before (C)
; and
(B)by inserting
after the semicolon at the end the following and (D) diabetes screening
tests (as defined in section 1861(yy)(1)) for an individual at risk for
diabetes (as defined in subsection (y)) at such intervals as are consistent
with the requirements of subparagraph (B), or in the case of an individual 21
years of age or older, standards established by the Secretary under section
1861(yy)(3);
; and
(2)by adding at the
end the following new subsection:
(y)For purposes of
subsection (a)(4)(D), the term individual at risk for diabetes
means—
(1)an individual 45
years of age or older who is overweight, defined as a body mass index greater
than 25 kg/m²; and
(2)an individual
under 45 years of age who is overweight (as so defined) and who has any of the
following risk factors for diabetes:
(A)A first-degree
relative with diabetes.
(B)Hypertension.
(C)Dyslipidemia.
(D)Habitually
inactive.
(E)Member of a high
risk ethnic population for diabetes, including a member of the following
populations:
(i)African
American.
(ii)Latino/Hispanic.
(iii)American
Indian.
(iv)Alaskan
Native.
(v)Asian
American.
(vi)Pacific
Islander.
(F)Previous
identification of an impaired fasting glucose or an impaired glucose
tolerance.
(G)A history of
gestational diabetes mellitus or delivery of a baby weighing greater than 9
pounds.
(H)Polycystic
ovarian disease.
(I)A history of
vascular
disease.
.
(b)Comprehensive
package of benefits for individuals with diabetes
(1)Section 1902(a) of the Social Security Act (42 U.S.C.
1396a(a)) is amended—
(A)in paragraph
(69), by striking and
at the end;
(B)in paragraph
(70)(B)(iv), by striking the period at the end and inserting ;
and
; and
(C)by inserting
after paragraph (70)(B)(iv), the following new paragraph:
(71)provide that the
medical assistance furnished to any individual who has been determined to be
eligible for such assistance and diagnosed with diabetes shall include, in
addition to any other items and services required to be furnished to the
individual under this title, at least the following items and services as
required by the individual's treating physician or healthcare provider:
(A)The care and
services listed in paragraphs (1), (2), (3), (4)(B), (4)(D), (5), (10), and
(12) (without regard, in the case of prescribed drugs, to any limit imposed
under the State plan on the number of prescriptions filled per month, but
subject to any such limit imposed by the treating physician or healthcare
provider) of section 1905(a).
(B)Durable medical
equipment (as defined in section 1861(n)) and other durable medical equipment
covered under title XVIII through national coverage determinations, including
insulin pumps and associated supplies.
(C)Services related
to pregnancy (including prenatal, delivery, and post partum services).
(D)A yearly dilated
eye exam by an eye care professional with appropriate follow-up care as
medically needed.
(E)Podiatric
services.
(F)Diabetes
education, including diabetes outpatient self-management training services (as
defined in section 1861(qq)).
(G)Medical nutrition
therapy services (as defined in section
1861(vv)(1)).
.
(2)Prohibition on
cost sharing
(A)Section 1916 of the Social Security Act (42 U.S.C. 1396o)
is amended by adding at the end the following new subsection:
(j)In the case of an
individual who has been determined to be eligible for medical assistance and
diagnosed with diabetes—
(1)no deduction,
cost sharing, or similar charge shall be imposed for any item or service listed
in subparagraph (A) through (G) of section 1902(a)(71) that is provided to the
individual as a result of the individual's diagnosis with diabetes or
complications related to such diagnosis; and
(2)the State option
to impose cost sharing under section 1916A shall not apply with respect to the
provision of medical assistance to such individual for any item or service
listed in subparagraph (A) through (G) of section 1902(a)(71) that is provided
to the individual as a result of the individual's diagnosis with diabetes or
complications related to such
diagnosis.
.
(B)The second sentence of section 1916A(a)(1) of the
Social Security Act (42 U.S.C. 1396o–1(a)(1)) is amended by striking
section 1916(g)
and inserting subsection (g) or (j) of
section 1916
.
(c)
(1)Except as provided in paragraph (2), the amendments made
by this section take effect on October 1, 2007.
(2)Extension of
effective date for state law amendmentIn the case of a State
plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which
the Secretary of Health and Human Services determines requires State
legislation in order for the plan to meet the additional requirements imposed
by the amendments made by this section, the State plan shall not be regarded as
failing to comply with the requirements of such title solely on the basis of
its failure to meet these additional requirements before the first day of the
first calendar quarter beginning after the close of the first regular session
of the State legislature that begins after the date of enactment of this Act.
For purposes of the previous sentence, in the case of a State that has a 2-year
legislative session, each year of the session is considered to be a separate
regular session of the State legislature.