,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #abeg  ,,in ,,the ,,house ,,of  
,,representatives  ,march #ai1 #bjac    
,ms4 ,de,gette 7for herself and ,mr4    
,whitfield7 introduced the following    
bill2 which was referred to the         
,committee on ,energy and ,commerce1 and
 in addition to the ,committee on ,ways 
and ,means1 for a period to be          
subsequently determined by the ,speaker1
 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 reduce the
 occurrence of diabetes in ,medicare    
beneficiaries by extending coverage     
under ,medicare for medical nutrition   
therapy services to such beneficiaries  
with pre-diabetes or with risk factors  
for developing type #b diabetes4  #a4   
,short title ,this ,act may be cited as 
the ,preventing ,diabetes in ,medicare  
,act of #bjac4  #b4 ,findings ,congress 
finds the following3  7#a7 ,according to

 the ,centers for ,disease ,control and 
,prevention1 there are #gi1jjj1jjj      
adults with pre-diabetes in ,america4   
,the ,centers estimates that #ej percent
 of adults who are #fe years of age or  
older have pre-diabetes4 ,more than #ij 
percent of adults with pre-diabetes are 
unaware they have it4  7#b7 ,for a      
significant number of people with       
pre-diabetes1 early intervention can    
reverse elevated blood glucose levels to
 normal range and prevent diabetes and  
its complications completely or can     
significantly delay its onset4          
,according to the ,institute for        
,alternative ,futures1 if #ej percent of
 adults with pre-diabetes were able to  
successfully make lifestyle changes     
proven to prevent or delay diabetes1    
then by #bjbe approximately #d1gjj1jjj  
new cases of diabetes could be prevented
 at a cost savings of #cjj billion4     
7#c7 ,nearly #a-;in-#e hospitalizations 
in #bjjh were related to diabetes       
according to the ,agency for ,healthcare

 ,research and ,quality4  7#d7          
,preventing diabetes and its            
complications can save money and lives4 
,the average annual cost to treat       
someone with diabetes is #aa1gdd1       
compared to #b1ice for someone who does 
not have diabetes4 ,one out of every    
three ,medicare dollars is spent on     
diabetes4  7#e7 ,diabetes is unique     
because its complications and their     
associated health care costs are often  
preventable with currently available    
medical treatment and lifestyle changes4
  7#f7 ,in #bjjb1 the ,diabetes         
,prevention ,program study conducted by 
the ,national ,institutes of ,health    
found that participants 7all of whom    
were at increased risk of developing    
type #b diabetes7 who made lifestyle    
changes reduced their risk of developing
 type #b diabetes by #eh percent and    
that participants who are #fj years of  
age or older reduced their risk of      
developing diabetes by #ga percent4     
7#g7 ,the ,agency for ,healthcare       

,research and ,quality has demonstrated 
that #b1ejj1jjj1jjj in hospitalization  
costs related to the treatment of       
diabetes or complications resulting from
 diabetes could be saved by providing   
seniors with appropriate primary care to
 prevent the onset of diabetes4  7#h7   
,the ,medicare program currently        
provides coverage for screening and     
identifying beneficiaries with          
pre-diabetes but does not provide       
adequate services to such beneficiaries 
to help them prevent or delay the onset 
of diabetes4  #c4 ,medicare coverage of 
medical nutrition therapy services for  
people with pre-diabetes and risk       
factors for developing type #b diabetes 
7a7 ,in general ,section #ahfa of the   
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7 is amended--  7#a7 in subsection
 7s77#b77,v71 by striking with diabetes 
or a renal disease and inserting with   
diabetes1 pre-diabetes 7as defined in   
subsection 7yy77#d771 or a renal        
disease1 or an individual at risk for   

diabetes 7as defined in subsection      
7yy77#b7712 and  7#b7 in subsection     
7yy7--  7,a7 in the heading1 by adding 2
 ,pre-,diabetes at the end2 and  7,b7 by
 adding at the end the following new    
paragraph3  7#d7 ,the term pre-diabetes 
means a condition of impaired fasting   
glucose or impaired glucose tolerance   
identified by a blood glucose level that
 is higher than normal1 but not so high 
as to indicate actual diabetes4  4  7b7 
,effective date ,the amendments made by 
this section shall apply with respect to
 services furnished on or after ,january
 #a1 #bjad4