Diabetes Self-Management Training Act of 2003 - Amends title XVIII (Medicare) of the Social Security Act to provide for the recognition of certified diabetes educators as Medicare providers for purposes of diabetes outpatient self-management training services.
Directs the Comptroller General to study and report to Congress on: (1) the barriers, if any, that exist in rural areas to successfully becoming a recognized diabetes education program, including the difficulty of rural health care professionals in becoming certified diabetes educators; and (2) whether individuals with diabetes who live in rural areas have barriers to accessing diabetes self-management training.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3194 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 3194
To amend title XVIII of the Social Security Act to improve access to
diabetes self-management training by designating certified diabetes
educators recognized by the National Certification Board of Diabetes
Educators as certified providers for purposes of outpatient diabetes
education services under part B of the Medicare Program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 25, 2003
Mr. Weldon of Pennsylvania (for himself and Ms. DeGette) 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 improve access to
diabetes self-management training by designating certified diabetes
educators recognized by the National Certification Board of Diabetes
Educators as certified providers for purposes of outpatient diabetes
education services under part B of the Medicare Program.
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 ``Diabetes Self-Management Training
Act of 2003''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Diabetes is the fifth leading cause of death in the
United States. Over 17,000,000 Americans (6.2 percent of the
population) currently are living with diabetes, a number that
is estimated to increase to 29,000,000 by the year 2050. In
2002, diabetes accounted for $132,000,000,000 in direct and
indirect health care costs. Diabetes is widely recognized as
one of the top public health threats facing our nation today.
(2) Diabetes can occur in 2 forms--type 1 diabetes is
caused by the body's inability to produce insulin, a hormone
that allows glucose or sugar to enter and fuel cells, and type
2 diabetes, which occurs when the body fails to make enough
insulin, or fails to properly use it. People with type 1
diabetes are required to take daily insulin injections to stay
alive. While some people with type 2 diabetes need insulin
shots, others with type 2 diabetes can control their diabetes
through healthy diet, nutrition, and lifestyle changes. Type 2
diabetes accounts for up to 95 percent of all diabetes cases
affecting 8 percent of the population age 20 and older. The
prevalence of type 2 diabetes has tripled in the last 30 years,
with much of that increase due to an upsurge in obesity.
(3) The Diabetes Prevention Program study in 2002 found
that participants (all of whom were at increased risk of
developing type 2 diabetes) who made lifestyle changes reduced
their risk of getting type 2 diabetes by 58 percent.
(4) Diabetes self-management training (DSMT) also called
diabetes education, provides knowledge and skill training to
patients with diabetes, helping them identify barriers,
facilitate problem solving, and develop coping skills to
effectively manage their diabetes. Unlike many other diseases,
diabetes requires constant vigilance on the part of the patient
and demands far more than just taking pills or insulin shots. A
certified diabetes educator is a health care professional--
often a nurse, dietitian, or pharmacist, who specializes in
helping people with diabetes develop the self-management skills
needed to stay healthy and avoid costly acute complications and
emergency care, as well as debilitating secondary conditions
caused by diabetes.
(5) There are currently over 13,000 diabetes educators in
the United States, most of whom are certified diabetes
educators (CDEs). To earn a CDE designation, a health care
professional must be licensed or have received a masters degree
in a relevant public health concentration, have completed 2
years of professional practice experience in diabetes self-
management training, and have provided a minimum of 1000 hours
of diabetes self-management training. Many other health care
professionals that are able to bill for diabetes education
through the medicare program have far less experience or
ability to provide the skilled expertise to help people with
diabetes self-manage the disease. CDEs are the best trained
health care professionals to provide DSMT and their experience
and background is in stark contrast to the 12 hours of
continuing education that non-physician health care providers
or suppliers must obtain every 2 years, as required by the
Centers for Medicare & Medicaid Services.
(6) CDEs represent the only group of health care
professionals who provide diabetes self-management training
that have not been recognized as health care providers and are
therefore precluded from directly billing the medicare program
for DSMT. Adding CDEs as providers to that program would give
diabetes patients access to the care they need.
SEC. 3. RECOGNITION OF CERTIFIED DIABETES EDUCATORS AS MEDICARE
PROVIDERS FOR PURPOSES OF DIABETES OUTPATIENT SELF-
MANAGEMENT TRAINING SERVICES.
(a) In General.--Section 1861(qq) of the Social Security Act (42
U.S.C. 1395x(qq)) is amended--
(1) in paragraph (2)--
(A) in subparagraph (A), by inserting ``and
includes a certified diabetes educator (as defined in
paragraph (3)) who is recognized by the National
Certification Board of Diabetes Educators and is
working within a recognized diabetes education
program'' before the semicolon at the end; and
(B) in subparagraph (B), by inserting before the
period at the end the following: ``or is a certified
diabetes educator (as so defined) who is recognized by
the National Certification Board of Diabetes Educators
and is working within a recognized diabetes education
program''; and
(2) by adding at the end the following:
``(3) For purposes of paragraph (2), the term `certified diabetes
educator' means an individual who--
``(A) is a health care professional who specializes in
helping individuals with diabetes develop the self-management
skills needed to overcome the daily challenges and problems
caused by the disease;
``(B) is a licensed nurse, occupational therapist,
optometrist, pharmacist, physical therapist, physician
assistant, podiatrist, a registered dietitian, or has an
advanced degree in nutrition, social work, clinical psychology,
exercise physiology, health education or a related public
health area such as health education, health promotion, health
and social behavior or health communication;
``(C) has at least 2 years of professional practice
experience in diabetes self-management training;
``(D) has provided a minimum of 1000 hours of diabetes
self-management training to patients within the most recent 5
years; and
``(E) has passed a certification exam approved by the
National Certification Board of Diabetes Educators.''.
(b) GAO Study and Report.--
(1) Study.--The Comptroller General of the United States
shall conduct a study to determine the barriers, if any, that
exist in rural areas to successfully becoming a recognized
diabetes education program, including the difficulty of rural
health care professionals in becoming certified diabetes
educators (as defined in section 1861(qq)(3) of the Social
Security Act (as added by subsection (a)(2))), and whether
individuals with diabetes who live in rural areas have barriers
to accessing diabetes self-management training.
(2) Report.--Not later than 1 year after the date of
enactment of this Act, the Comptroller General of the United
States shall submit a report to Congress regarding the study
conducted under paragraph (2).
(c) Effective Date.--The amendments made by subsection (a) apply to
diabetes outpatient self-management training services furnished on or
after October 1, 2003.
<all>
Introduced in House
Introduced in House
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.
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.
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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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