Medicare Diabetes Self-Management Training Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act to recognize state-licensed or -registered health care professionals who are certified diabetes educators in an outpatient setting as authorized providers of Medicare diabetes outpatient self-management training services, including as part of telehealth services, under Medicare part B (Supplementary Medical Insurance).
Directs the Comptroller General to study the barriers that exist for Medicare beneficiaries with diabetes in accessing diabetes self-management training services under the Medicare program.
Directs the Director of the Agency for Health Care Research and Quality of the Department of Health and Human Services (HHS) to develop a series of recommendations on effective outreach methods to educate primary care physicians and the public about the benefits of diabetes self-management training.
[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2787 Introduced in House (IH)]
112th CONGRESS
1st Session
H. R. 2787
To amend title XVIII of the Social Security Act to improve access to
diabetes self-management training by authorizing certified diabetes
educators to provide diabetes self-management training services,
including as part of telehealth services, under part B of the Medicare
program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
August 1, 2011
Mr. Whitfield (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 authorizing certified diabetes
educators to provide diabetes self-management training services,
including as part of telehealth 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 ``Medicare Diabetes Self-Management
Training Act of 2011''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Diabetes self-management training, also called diabetes
education, provides critical knowledge and skills training to
patients with diabetes, helping them manage medications,
address nutritional issues, facilitate diabetes-related problem
solving, and make other critical lifestyle changes to
effectively manage their diabetes.
(2) A certified diabetes educator is a State licensed or
registered health care professional 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.
(3) Diabetes self-management training has been proven
effective in helping to reduce the risks and complications of
diabetes and is a vital component of an overall diabetes
treatment regimen. Patients under the care of a certified
diabetes educator are better able to control their diabetes and
improve their health status.
(4) Lifestyle changes, such as those taught by certified
diabetes educators, directly contribute to better glycemic
control and reduced complications from diabetes. Evidence shows
that the potential for prevention of the most serious medical
complications caused by diabetes to be as high as 90 percent
(blindness), 85 percent (amputations), and 50 percent (heart
disease and stroke) with proper medical treatment and active
self-management.
(5) Despite its effectiveness in reducing diabetes-related
complications and associated costs, diabetes self-management
training has been recognized by policymakers as an
underutilized Medicare benefit. Enhancing access to diabetes
self-management training programs that are taught by Certified
Diabetes Educators is an important public policy goal that can
help improve health outcomes, ensure quality, and reduce
escalating diabetes-related health costs.
SEC. 3. RECOGNITION OF CERTIFIED DIABETES EDUCATORS AS AUTHORIZED
PROVIDERS OF MEDICARE 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 (1), by striking ``by a certified provider
(as described in paragraph (2)(A)) in an outpatient setting''
and inserting ``in an outpatient setting by a certified
diabetes educator (as defined in paragraph (3)) or by a
certified provider (as described in paragraph (2)(A))''; and
(2) by adding at the end the following new paragraphs:
``(3) For purposes of paragraph (1), the term `certified diabetes
educator' means an individual who--
``(A) is licensed or registered by the State in which the
services are performed as a health care professional;
``(B) specializes in teaching individuals with diabetes to
develop the necessary skills and knowledge to manage the
individual's diabetic condition; and
``(C) is certified as a diabetes educator by a recognized
certifying body (as defined in paragraph (4)).
``(4) For purposes of paragraph (3)(C), the term `recognized
certifying body' means a certifying body for diabetes educators which
is recognized by the Secretary as authorized to grant certification of
diabetes educators for purposes of this subsection pursuant to
standards established by the Secretary.''.
(b) Treatment as a Practitioner, Including for Telehealth
Services.--Section 1842(b)(18)(C) of the such Act (42 U.S.C.
1395u(b)(18)(C)) is amended by adding at the end the following new
clause:
``(vii) A certified diabetes educator (as defined in
section 1861(qq)(3)).''.
(c) GAO Study and Report.--
(1) Study.--The Comptroller General of the United States
shall conduct a study to identify the barriers that exist for
Medicare beneficiaries with diabetes in accessing diabetes
self-management training services under the Medicare program,
including economic and geographic barriers and availability of
appropriate referrals and access to adequate and qualified
providers.
(2) Report.--Not later than 1 year after the date of the
enactment of this Act, the Comptroller General of the United
States shall submit to Congress a report on the study conducted
under paragraph (1).
(d) AHRQ Development of Recommendations for Outreach Methods and
Report.--
(1) Development of recommendations.--The Director of the
Agency for Healthcare Research and Quality shall, through use
of a workshop and other appropriate means, develop a series of
recommendations on effective outreach methods to educate
primary care physicians and the public about the benefits of
diabetes self-management training in order to promote better
health outcomes for patients with diabetes.
(2) Report.--Not later than 1 year after the date of the
enactment of this Act, the Director of the Agency for
Healthcare Research and Quality shall submit to Congress a
report on the recommendations developed under paragraph (1).
(e) Effective Date.--The amendments made by this section shall
apply to items and services furnished on or after January 1, 2013.
<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 Subcommittee on Health.
Referred to the Subcommittee on Health.
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