[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1184 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                S. 1184

To amend title XVIII of the Social Security Act to include information 
  on the coverage of intensive behavioral therapy for obesity in the 
   Medicare and You Handbook and to provide for the coordination of 
     programs to prevent and treat obesity, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 19, 2013

  Mr. Carper (for himself and Ms. Murkowski) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to include information 
  on the coverage of intensive behavioral therapy for obesity in the 
   Medicare and You Handbook and to provide for the coordination of 
     programs to prevent and treat obesity, 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 ``Treat and Reduce Obesity Act of 
2013''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) According to the Centers for Disease Control and 
        Prevention, about 35 percent of adults aged 65 and over were 
        obese in the period of 2007 through 2010, representing over 8 
        million adults aged 65 through 74.
            (2) Obesity increases the risk for chronic diseases and 
        conditions, including high blood pressure, heart disease, and 
        type 2 diabetes.
            (3) More than half of Medicare beneficiaries are treated 
        for 5 or more chronic conditions per year. The rate of obesity 
        among Medicare patients doubled from 1987 to 2002, and spending 
        on those individuals more than doubled.
            (4) Obese men and women at age 65 have decreased life 
        expectancy of 1.6 years for men and 1.4 years for women.
            (5) The direct and indirect cost of obesity is more than 
        $450 billion annually.
            (6) On average, an obese Medicare beneficiary costs $1,964 
        more than a normal-weight beneficiary.
            (7) The prevalence of obesity among older Americans is 
        growing at a linear rate and, left unchanged, nearly half of 
        the elderly population will be obese in 2030 according to a 
        Congressional Research Report on obesity.

SEC. 3. INCLUSION OF INFORMATION ON COVERAGE OF INTENSIVE BEHAVIORAL 
              THERAPY FOR OBESITY IN THE MEDICARE AND YOU HANDBOOK.

    (a) In General.--Section 1804(a) of the Social Security Act (42 
U.S.C. 1395b-2(a)) is amended--
            (1) in paragraph (2), by striking ``and'' at the end;
            (2) in paragraph (3), by striking the period at the end and 
        inserting ``, and''; and
            (3) by inserting after paragraph (3) the following new 
        paragraph:
            ``(4) information on the coverage of intensive behavioral 
        therapy for obesity under this title, including information 
        regarding primary care physicians and other providers of 
        services and suppliers who are eligible to furnish such 
        therapy.''.
    (b) Effective Date.--The amendments made by this section shall 
apply to notices distributed on or after the date of enactment of this 
Act.

SEC. 4. PLAN FOR COORDINATION OF HHS EFFORTS; PROVIDING THE SECRETARY 
              OF HEALTH AND HUMAN SERVICES WITH AUTHORITY TO COORDINATE 
              PROGRAMS TO PREVENT AND TREAT OBESITY AND EXPAND COVERAGE 
              OPTIONS FOR OBESITY UNDER MEDICARE.

    Section 1861(ddd) of the Social Security Act (42 U.S.C. 
1395x(ddd)), as amended by section 3, is amended by adding at the end 
the following new paragraph:
    ``(5)(A) Not later than 1 year after the date of enactment of the 
Treat and Reduce Obesity Act of 2013, the Secretary shall develop and 
implement a plan to coordinate the efforts of all offices and agencies 
of the Department of Health and Human Services (such as the Centers for 
Medicare & Medicaid Services, the Centers for Disease Control and 
Prevention, the National Institutes of Health, the Health Resources and 
Services Administration, and other offices and agencies) to treat, 
reduce, and prevent obesity and overweight in the adult population. 
Beginning 2 years after such date of enactment, the Secretary shall 
annually update such plan.
    ``(B) In developing and implementing the plan under subparagraph 
(A), the Secretary shall work with at least 5 representatives, selected 
by the Secretary, of expert organizations (such as public health 
associations, physician associations, key healthcare provider groups, 
planning and development organizations, education associations, 
advocacy groups, patient groups, relevant industries, State and local 
leadership, and other entities as determined appropriate by the 
Secretary).
    ``(C) The Secretary shall ensure that the plan under subparagraph 
(A) is coordinated with the National Prevention Strategy and does not 
duplicate the efforts of the National Prevention Council and the 
National Prevention Strategy.
    ``(D) The plan under subparagraph (A) shall include the following:
            ``(i) Strategies to comprehensively treat and reduce 
        overweight and obesity.
            ``(ii) A description of--
                    ``(I) the coordination of interagency cooperation 
                under the plan; and
                    ``(II) actions under the plan related to the 
                treatment and reduction of overweight and obesity in 
                the United States.
            ``(iii) Identification of best practices in States, 
        communities, organizations, businesses, and other entities as 
        appropriate, regarding treatment of overweight and obesity.
            ``(iv) A description of collaboration with States, 
        communities, organizations, businesses, and other appropriate 
        entities to evaluate the effectiveness of obesity and 
        overweight interventions under the plan.
            ``(v) Research initiatives, including ongoing surveillance 
        and monitoring using tools such as the National Health and 
        Nutrition Examination Survey and the Behavioral Risk Factor 
        Surveillance System and assurances for adequate and consistent 
        funding to support data collection and analysis to inform 
        policy under the plan.
            ``(vi) Recommendations for the coordination of budgets, 
        grant and pilot programs, policies, and programs across Federal 
        agencies to cohesively treat overweight and obesity.
    ``(E) Not later than 24 months after the date of enactment of the 
Treat and Reduce Obesity Act of 2013, and on an annual basis 
thereafter, the Secretary shall submit to the President and to the 
relevant committees of Congress, a report that--
            ``(i) summarizes the plan under subparagraph (A) to 
        coordinate interagency efforts surrounding the treatment, 
        reduction, and prevention of obesity and overweight, including 
        a detailed strategic plan with recommendations for each office 
        and agency involved;
            ``(ii) in the case of the second report submitted under 
        this subparagraph (and each subsequent report), evaluates the 
        effectiveness of those coordinated interventions and conducts 
        interim assessments and reporting of health outcomes, 
        achievement of milestones, and implementation of strategic plan 
        goals; and
            ``(iii) makes recommendations for updating the plan for the 
        following year based on data and findings from the previous 
        year.''.

SEC. 5. AUTHORITY TO EXPAND HEALTH CARE PROVIDERS QUALIFIED TO FURNISH 
              INTENSIVE BEHAVIORAL THERAPY.

    Section 1861(ddd) of the Social Security Act (42 U.S.C. 
1395x(ddd)), as amended by sections 3 and 4, is amended by adding at 
the end the following new paragraph:
    ``(6)(A) The Secretary may, in addition to qualified primary care 
physicians and other primary care practitioners, cover intensive 
behavioral therapy for obesity--
            ``(i) furnished by a physician (as defined in subsection 
        (r)(1)) who is not a qualified primary care physician;
            ``(ii) furnished--
                    ``(I) by any other appropriate health care provider 
                (including a physician assistant, nurse practitioner, 
                or clinical nurse specialist (as those terms are 
                defined in subsection (aa)(5)), a clinical 
                psychologist, and a registered dietitian or nutrition 
                professional (as defined in subsection (vv));
                    ``(II) upon referral from, and in coordination 
                with, a physician or primary care practitioner 
                operating in a primary care setting or any other 
                setting specified by the Secretary; and
                    ``(III) in an office setting, a hospital outpatient 
                department, or another setting specified by the 
                Secretary; or
            ``(iii) furnished by an evidence-based, community-based 
        lifestyle counseling program certified by the Secretary.
    ``(B) In order to ensure a collaborative effort, the coordination 
described in subparagraph (A)(ii)(II) may include the health care 
provider communicating to the physician or primary care practitioner 
making the referral any recommendations or treatment plans made 
regarding the therapy.''.

SEC. 6. MEDICARE PART D COVERAGE OF OBESITY MEDICATION.

    (a) In General.--Section 1860D-2(e)(2)(A) of the Social Security 
Act (42 U.S.C. 1395w-102(e)(2)(A)) is amended by inserting after 
``restricted under section 1927(d)(2),'' the following, ``other than 
subparagraph (A) of such section if the drug is used for the treatment 
of obesity (as defined for purposes of section 1861(yy)(2)(C)) or for 
being overweight (as defined for purposes of section 1861(yy)(2)(F)(i)) 
and if the individual has one or more comorbidities,''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to plan years beginning on or after the date that is 2 years 
after the date of enactment of this Act.
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