I 111th CONGRESS 1st Session H. R. 2590 IN THE HOUSE OF REPRESENTATIVES May 21, 2009 Ms. DeGette (for herself, Mr. Castle, Mr. Becerra, and Mr. Kirk) 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 reduce the occurrence of diabetes in Medicare beneficiaries by extending coverage under Medicare for medical nutrition therapy services to such beneficiaries with pre-diabetes or with risk factors for developing type 2 diabetes.

1.

Short title

This Act may be cited as the Preventing Diabetes in Medicare Act of 2009.

2.

Findings

Congress finds the following: (1)According to the American Diabetes Association, there are 57,000,000 people with pre-diabetes in America. (2)For a significant number of people with pre-diabetes, intervening early can reverse elevated blood glucose levels to normal range and prevent diabetes and its complications completely. (3)Diabetes-related hospitalizations totaled 24.3 million days in 2007, an increase of 7.4 million from the 16.9 million days in 2002. (4)Preventing diabetes and its complications can save money and lives. The average annual cost to treat someone with diabetes is $11,744. (5)Diabetes is unique because its complications and their associated health care cost are preventable with currently available medical treatment and lifestyle changes. (6)In 2002, the Diabetes Prevention Program study conducted by the National Institutes of Health found that participants (all of whom were at increased risk of developing type 2 diabetes) who made lifestyle changes reduced their risk of developing type 2 diabetes by 58 percent and that participants aged 60 and older reduced their risk of developing diabetes by 71 percent. (7)The Agency for Healthcare Research and Quality (AHRQ) has demonstrated that $2,500,000,000 in hospitalization costs related to the treatment of diabetes or complications resulting from diabetes could be saved by providing seniors with appropriate primary care to prevent the onset of diabetes. (8)The Medicare program currently screens and identifies beneficiaries with pre-diabetes but does not provide adequate services to such beneficiaries to prevent them from becoming diabetic.

3.

Medicare coverage of medical nutrition therapy services for people with pre-diabetes and risk factors for developing type 2 diabetes

(a)

In general

Subsection (s)(2)(V) of section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended— (1)by inserting , pre-diabetes (as defined in subsection (hhh)), after with diabetes; and (2)by inserting , or an individual at risk for diabetes (as defined in subsection (yy)(2)), after or a renal disease. (b)

Definition of pre-diabetes

Such section is further amended by adding at the end the following new subsection: (hhh)

Pre-diabetes

The term pre-diabetes means a condition of impaired fasting glucose or impaired glucose tolerance identified by a blood glucose level that is higher than normal, but not so high as to indicate actual diabetes. . (c)

Effective date

The amendments made by this section shall apply with respect to services furnished on or after January 1, 2010.