[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4378 Introduced in House (IH)]

113th CONGRESS
  2d Session
                                H. R. 4378

   To require the Secretary of Health and Human Services to issue to 
Federal agencies guidelines for developing procedures and requirements 
     relating to certain primary care Federal health professionals 
  completing continuing medical education on nutrition and to require 
Federal agencies to submit annual reports relating to such guidelines, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 2, 2014

    Mr. Grijalva (for himself and Mr. Ryan of Ohio) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
   To require the Secretary of Health and Human Services to issue to 
Federal agencies guidelines for developing procedures and requirements 
     relating to certain primary care Federal health professionals 
  completing continuing medical education on nutrition and to require 
Federal agencies to submit annual reports relating to such guidelines, 
                        and for other purposes.

    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 ``Education and Training for Health 
Act of 2014'' or the ``EAT for Health Act of 2014''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) In 2012, United States health care spending was 
        approximately $8,233 per resident and accounted for 17.6 
        percent of the Nation's gross domestic product. This is among 
        the highest of all industrialized countries.
            (2) Expenditures in the United States on health care 
        surpassed $2.6 trillion in 2011, more than three times the $714 
        billion spent in 1990, and over eight times the $253 billion 
        spent in 1980.
            (3) Estimates of health care costs attribute over 75 
        percent of national health expenditures to treatment for 
        chronic diseases.
            (4) A March 2003 report from the World Health Organization 
        concluded diet was a major cause of chronic diseases.
            (5) Seven out of 10 deaths among people in the United 
        States each year are from chronic diseases such as 
        cardiovascular disease, obesity, diabetes, and cancer.
            (6) Approximately 81.1 million American adults in the 
        United States have at least one form of cardiovascular disease. 
        Approximately 2,300 American adults in the United States die 
        every day from cardiovascular disease. In 2010, cardiovascular 
        disease cost American taxpayers $189.4 billion. The American 
        Heart Association estimates that, by 2030, direct costs related 
        to cardiovascular disease will triple to around $818 billion.
            (7) Research has shown that following a healthful diet can 
        not only reduce symptoms related to cardiovascular disease but 
        also actually reverse damage done to the arteries.
            (8) Two-thirds of adults in the United States are currently 
        overweight, and half of those overweight individuals are obese. 
        One in three children are now overweight, and one-fifth of 
        children are obese. In 2008, direct medical costs associated 
        with obesity totaled $147 billion.
            (9) An estimated 25.8 million people in the United States 
        have diabetes. Another 79 million American adults in the United 
        States have prediabetes. The Centers for Disease Control and 
        Prevention predict that one in three children born in 2000 will 
        develop diabetes at some point in their lives. Total estimated 
        costs of diagnosed diabetes have increased 41 percent, to $245 
        billion in 2012 from $174 billion in 2007. Research shows that 
        reducing fat in the diet can reverse the symptoms of type 2 
        diabetes, not just ``manage'' the symptoms.
            (10) Cancer kills approximately 570,000 Americans each 
        year, accounting for one in four deaths. More than 1.5 million 
        new cancer cases are diagnosed annually. In 2010, the direct 
        costs of cancer were $102.8 billion. Estimates expect that 
        number to rise to $172 billion by 2020.
            (11) According to the Journal of the American College of 
        Nutrition, physicians feel inadequately trained to provide 
        proper nutrition advice. Ninety-four percent feel nutrition 
        counseling should be included during primary care visits, but 
        only 14 percent felt adequately trained to provide such 
        counseling.
            (12) A 1985 National Academy of Sciences report recommended 
        that all medical schools require at least 25 contact hours of 
        nutrition education. In 2004, only 38 percent of medical 
        schools met these minimum standards by requiring 25 hours of 
        nutrition education as part of their general curricula. By 
        2010, that number had shrunk to 27 percent.
            (13) In 2004, 30 percent of United States medical schools 
        required a dedicated nutrition course. In 2010, only 25 percent 
        of such schools required such a course.
            (14) According to a 2009 national survey of medical 
        colleges published in Academic Medicine, more than half of 
        graduating medical students feel their nutrition education is 
        insufficient.

SEC. 3. DEPARTMENT OF HEALTH AND HUMAN SERVICES GUIDELINES, AND FEDERAL 
              AGENCIES ANNUAL REPORTS, RELATING TO CERTAIN PRIMARY CARE 
              FEDERAL HEALTH PROFESSIONALS COMPLETING CONTINUING 
              MEDICAL EDUCATION ON NUTRITION.

    (a) Guidelines.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
issue guidelines to Federal agencies for developing procedures and 
requirements to ensure that every primary care health professional 
employed full-time for such agencies have at least 6 credits of 
continuing medical education courses relating to nutrition (as 
described in subsection (c)).
    (b) Annual Reports.--For 2016 and each subsequent year, the head of 
each Federal agency that employs full-time primary care health 
professionals shall submit to Congress a report attesting, in a form 
and manner specified by the Secretary of Health and Human Services, to 
the extent to which the agency has adopted and enforced the guidelines 
issued under subsection (a) with respect to such professionals employed 
by such agency during any portion of the previous year. If the agency, 
with respect to such previous year, did not fully adopt and enforce 
such guidelines with respect to such professionals, the head of the 
agency shall include in the report for the year the percentage of such 
professionals employed by such agency to furnish primary care services 
who during such previous year completed 6 credits of continuing medical 
education courses relating to nutrition (as described in subsection 
(c)).
    (c) Continuing Medical Education Relating to Nutrition.--For 
purposes of subsections (a) and (b), continuing medical education 
courses relating to nutrition shall include at least courses on the 
role of nutrition in the prevention, management, and, as possible, 
reversal of obesity, cardiovascular disease, diabetes, and cancer.
    (d) Definitions.--For purposes of this Act:
            (1) Primary care health professional.--The term ``primary 
        care health professional'' means a physician or nurse 
        practitioner who furnishes primary care services.
            (2) Nurse practitioner.--The term ``nurse practitioner'' 
        has the meaning given such term in section 1861(aa)(5) of the 
        Social Security Act (42 U.S.C. 1395x(aa)(5)).
            (3) Physician.--The term ``physician'' has the meaning 
        given such term in section 1861(r)(1) of the Social Security 
        Act (42 U.S.C. 1395x(r)(1)).
            (4) Primary care services.--The term ``primary care 
        services'' has the meaning given such term in section 
        1842(i)(4) of the Social Security Act (42 U.S.C. 1395u(i)(4)), 
        but shall include such services furnished by a nurse 
        practitioner as would otherwise be included if furnished by a 
        physician.
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