[Congressional Record Volume 158, Number 115 (Tuesday, July 31, 2012)]
[Senate]
[Pages S5736-S5737]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FRANKEN (for himself, Mr. Lugar, Mr. Rockefeller, Ms. 
        Collins, Mrs. Shaheen, Mr. Wyden, Mr. Blumenthal, and Mr. Brown 
        of Ohio):
  S. 3463. A bill to amend title XVIII of the Social Security Act to 
reduce the incidence of diabetes among Medicare beneficiaries; to the 
Committee on Finance.
  Mr. ROCKEFELLER. Mr. President, I am pleased to join today with my 
colleagues, Senator Franken, Senator Lugar, Senator Collins, Senator 
Shaheen, Senator Wyden, Senator Blumenthal, and Senator Brown of Ohio, 
to introduce an important piece of bipartisan legislation, the Medicare 
Diabetes Prevention Act of 2012. Our legislation makes a wise 
investment in seniors' health by extending the proven

[[Page S5737]]

success of the National Diabetes Prevention Program to Medicare. Nearly 
26 million American adults have diabetes, and if this disturbing trend 
doesn't stop, over half of the adult population will either have Type 2 
diabetes or its precursor, ``prediabetes,'' by 2020.
  Sadly, my home State of West Virginia has one of the highest diabetes 
rates in the Nation. In 2009, approximately 174,000 adults, which is 11 
percent of West Virginia adults, had diabetes. According to Centers for 
Disease Control estimates, as many as 50 percent of the nearly 380,000 
people with Medicare in West Virginia may be at risk of developing this 
serious, but preventable, illness. If current trends continue, one in 
three children born in West Virginia after the year 2000 will develop 
diabetes within his or her lifetime and people with diabetes risk 
developing terrible complications down the road, including heart 
disease, stroke, blindness, and amputations.
  Diabetes is also one of the main cost drivers in our health care 
system. The direct economic burden of diabetes was $116 billion for 
medical expenses and indirect costs totaled $58 billion due to 
disability, work loss, or premature death in 2007. The costs associated 
with this preventable disease for Medicare beneficiaries are expected 
to grow to $2 trillion over the 2011 to 2020 period.
  We simply cannot stand idly by in the face of such overwhelming 
statistics--and fortunately, there is a way to prevent Type 2 diabetes. 
The National Diabetes Prevention Program, NDPP, is an innovative 
approach that has demonstrated its effects in preventing the onset of 
Type 2 diabetes. The NDPP is a proven, community-based intervention 
that focuses on changing lifestyle behaviors of prediabetic overweight 
or obese adults through activities that improve dietary choices and 
increase physical activity in a group setting. In a large-scale 
clinical trial that has been replicated in community settings, NDPP 
successfully reduced the onset of diabetes by 58 percent overall and 71 
percent in adults over 60.
  Because of the impressive success of the National Diabetes Prevention 
Program, I believe our seniors should have access to its benefits. The 
Medicare Diabetes Prevention Act of 2012 will help seniors prevent Type 
2 diabetes by allowing Medicare to provide the National Diabetes 
Prevention Program through community settings like the YMCA, local 
health departments, or even the local church, reaching people with 
Medicare wherever they live. In the past, physicians have had few tools 
for their patients who are found to be at risk of diabetes. Under this 
bill, if a senior is found at risk for diabetes, for example, through 
their annual wellness visit, their doctor will be able to refer them to 
an NDPP program in their area.
  Unlike Medicare, which needs a Federal legislative change to cover 
this program, State Medicaid programs already have the authority to pay 
for this innovative initiative, and it is my hope that more states will 
do so. By 2020, Medicaid is expected to cover 13 million people with 
diabetes and about 9 million people who may have pre-diabetes, and 
states will spend an estimated $83 billion on individuals with diabetes 
or pre-diabetes. The National Diabetes Prevention program presents an 
opportunity for States to reduce the incidence of diabetes among 
individuals enrolled in their Medicaid programs, an especially 
strategic investment when combined with the expansion of the Medicaid 
program under health reform.
  The coverage of proven solutions under Medicare is nothing new. Yet, 
rather than providing a traditional drug or procedure, NDPP allows at-
risk individuals to change their lifestyles through a community 
intervention. Implementing NDPP is a unique response to the alarming 
and escalating rates of diabetes. This public health solution has 
demonstrated tangible results that can enable our country to prevent 
diabetes, while reducing health care costs. The NDPP is a strategic and 
cost-effective intervention that costs less than $500 per person to 
deliver, compared to the estimated $15,000 per year spent on each 
Medicare beneficiary with diabetes. According to the Urban Institute, 
implementing the NDPP nationally could save $191 billion over the next 
10 years, with 75 percent of the savings, $142.9 billion, going to the 
Medicare and Medicaid programs.
  Better yet, the National Diabetes Prevention Program is a job 
creator, bringing diabetes trainers to more communities nationwide to 
provide the program. West Virginia has already received funding from 
the Centers for Disease Control and Prevention through a Community 
Transformation Grant that will allow the State to train at least 100 
community health workers to help disseminate the Diabetes Prevention 
Program in the State over the next 5 years.
  The Medicare Diabetes Prevention Act has been endorsed by the 
American Diabetes Association, American Heart Association, American 
Public Health Association, National Association of Chronic Disease 
Directors, National Association of State Long-Term Care Ombudsman 
Programs, National Council on Aging, Novo Nordisk, Trust for America's 
Health, the YMCA of the USA, and State YMCA affiliates in over 45 
States. With so many Americans at risk for developing diabetes and its 
potentially severe complications, today is the right time for Medicare 
to extend the proven National Diabetes Prevention Program as a covered 
benefit to seniors.
  I urge my colleagues to support this timely and important piece of 
legislation.
                                 ______