,,ii  #aacth ,,congress  #ast ,session  
,s4 #aahd  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #ai1     
#bjac ,mr4 ,carper 7for himself and ,ms4
 ,murkowski7 introduced the following   
bill2 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 obesity1 and for other purposes4  
#a4 ,short title ,this ,act may be cited
 as the ,treat and ,reduce ,obesity ,act
 of #bjac4  #b4 ,findings ,congress     
makes the following findings3  7#a7     
,according to the ,centers for ,disease 
,control and ,prevention1 about #ce     
percent of adults aged #fe and over were
 obese in the period of #bjjg through   
#bjaj1 representing over #h million     
adults aged #fe through #gd4  7#b7      
,obesity increases the risk for chronic 

diseases and conditions1 including high 
blood pressure1 heart disease1 and type 
#b diabetes4  7#c7 ,more than half of   
,medicare beneficiaries are treated for 
#e or more chronic conditions per year4 
,the rate of obesity among ,medicare    
patients doubled from #aihg to #bjjb1   
and spending on those individuals more  
than doubled4  7#d7 ,obese men and women
 at age #fe have decreased life         
expectancy of #a4f years for men and    
#a4d years for women4  7#e7 ,the direct 
and indirect cost of obesity is more    
than #dej billion annually4  7#f7 ,on   
average1 an obese ,medicare beneficiary 
costs #a1ifd more than a normal-weight  
beneficiary4  7#g7 ,the prevalence of   
obesity among older ,americans is       
growing at a linear rate and1 left      
unchanged1 nearly half of the elderly   
population will be obese in #bjcj       
according to a ,congressional ,research 
,report on obesity4  #c4 ,inclusion of  
information on coverage of intensive    
behavioral therapy for obesity in the   

,medicare and ,you ,handbook  7a7 ,in   
general ,section #ahjd7;a7 of the       
,social ,security ,act 7#db ,u4,s4,c4   
#acie;b-#b7;a77 is amended--  7#a7 in   
paragraph 7#b71 by striking 8and0 at the
 end2  7#b7 in paragraph 7#c71 by       
striking the period at the end and      
inserting 1 and2 and  7#c7 by inserting 
after paragraph 7#c7 the following new  
paragraph3  7#d7 information on the     
coverage of intensive behavioral therapy
 for obesity under this title1 including
 information regarding primary care     
physicians and other providers of       
services and suppliers who are eligible 
to furnish such therapy4  4  7b7        
,effective date ,the amendments made by 
this section shall apply to notices     
distributed on or after the date of     
enactment of this ,act4  #d4 ,plan for  
coordination of ,,hhs efforts2 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 #ahfa7;ddd7 of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciex7ddd771 as amended by   
section #c1 is amended by adding at the 
end the following new paragraph3  7#e7  
7,a7 ,not later than #a year after the  
date of enactment of the ,treat and     
,reduce ,obesity ,act of #bjac1 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 7such as
 the ,centers for ,medicare  ,medicaid  
,services1 the ,centers for ,disease    
,control and ,prevention1 the ,national 
,institutes of ,health1 the ,health     
,resources and ,services                
,administration1 and other offices and  
agencies7 to treat1 reduce1 and prevent 
obesity and overweight in the adult     
population4 ,beginning #b years after   
such date of enactment1 the ,secretary  
shall annually update such plan4  7,b7  
,in developing and implementing the plan
 under subparagraph 7,a71 the ,secretary

 shall work with at least #e            
representatives1 selected by the        
,secretary1 of expert organizations     
7such as public health associations1    
physician associations1 key healthcare  
provider groups1 planning and           
development organizations1 education    
associations1 advocacy groups1 patient  
groups1 relevant industries1 ,state and 
local leadership1 and other entities as 
determined appropriate by the           
,secretary74  7,c7 ,the ,secretary shall
 ensure that the plan under subparagraph
 7,a7 is coordinated with the ,national 
,prevention ,strategy and does not      
duplicate the efforts of the ,national  
,prevention ,council and the ,national  
,prevention ,strategy4  7,d7 ,the plan  
under subparagraph 7,a7 shall include   
the following3  7i7 ,strategies to      
comprehensively treat and reduce        
overweight and obesity4  7ii7 ,a        
description of--  7,i7 the coordination 
of interagency cooperation under the    
plan2 and  7,,ii7 actions under the plan

 related to the treatment and reduction 
of overweight and obesity in the ,united
 ,states4  7iii7 ,identification of best
 practices in ,states1 communities1     
organizations1 businesses1 and other    
entities as appropriate1 regarding      
treatment of overweight and obesity4    
7iv7 ,a description of collaboration    
with ,states1 communities1              
organizations1 businesses1 and other    
appropriate entities to evaluate the    
effectiveness of obesity and overweight 
interventions under the plan4  7v7      
,research initiatives1 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 plan4  7vi7 ,recommendations 
for the coordination of budgets1 grant  
and pilot programs1 policies1 and       
programs across ,federal agencies to    

cohesively treat overweight and obesity4
  7,e7 ,not later than #bd months after 
the date of enactment of the ,treat and 
,reduce ,obesity ,act of #bjac1 and on  
an annual basis thereafter1 the         
,secretary shall submit to the          
,president and to the relevant          
committees of ,congress1 a report that--
  7i7 summarizes the plan under         
subparagraph 7,a7 to coordinate         
interagency efforts surrounding the     
treatment1 reduction1 and prevention of 
obesity and overweight1 including a     
detailed strategic plan with            
recommendations for each office and     
agency involved2  7ii7 in the case of   
the second report submitted under this  
subparagraph 7and each subsequent       
report71 evaluates the effectiveness of 
those coordinated interventions and     
conducts interim assessments and        
reporting of health outcomes1           
achievement of milestones1 and          
implementation of strategic plan goals2 
and  7iii7 makes recommendations for    

updating the plan for the following year
 based on data and findings from the    
previous year4  4  #e4 ,authority to    
expand health care providers qualified  
to furnish intensive behavioral therapy 
,section #ahfa7;ddd7 of the ,social     
,security ,act 7#db ,u4,s4,c4           
#aciex7ddd771 as amended by sections #c 
and #d1 is amended by adding at the end 
the following new paragraph3  7#f7 7,a7 
,the ,secretary may1 in addition to     
qualified primary care physicians and   
other primary care practitioners1 cover 
intensive behavioral therapy for        
obesity--  7i7 furnished by a physician 
7as defined in subsection 7r77#a77 who  
is not a qualified primary care         
physician2  7ii7 furnished--  7,i7 by   
any other appropriate health care       
provider 7including a physician         
assistant1 nurse practitioner1 or       
clinical nurse specialist 7as those     
terms are defined in subsection         
7aa77#e771 a clinical psychologist1 and 
a registered dietitian or nutrition     

professional 7as defined in subsection  
7vv772  7,,ii7 upon referral from1 and  
in coordination with1 a physician or    
primary care practitioner operating in a
 primary care setting or any other      
setting specified by the ,secretary2 and
  7,,iii7 in an office setting1 a       
hospital outpatient department1 or      
another setting specified by the        
,secretary2 or  7iii7 furnished by an   
evidence-based1 community-based         
lifestyle counseling program certified  
by the ,secretary4  7,b7 ,in order to   
ensure a collaborative effort1 the      
coordination described in subparagraph  
7,a77ii77,,ii7 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   
therapy4  4  #f4 ,medicare part ,d      
coverage of obesity medication  7a7 ,in 
general ,section                        
#ahfj;,d-#b7;e77#b77;,a7 of the ,social 
,security ,act 7#db ,u4,s4,c4           

#aciew-#ajb7;e77#b77;,a77 is amended by 
inserting after restricted under section
 #aibg7;d77#b71 the following1 other    
than subparagraph 7,a7 of such section  
if the drug is used for the treatment of
 obesity 7as defined for purposes of    
section #ahfa7yy77#b77;,c77 or for being
 overweight 7as defined for purposes of 
section #ahfa7yy77#b77;,f77i77 and if   
the individual has one or more          
comorbidities14  7b7 ,effective date    
,the amendment made by subsection 7a7   
shall apply to plan years beginning on  
or after the date that is #b years after
 the date of enactment of this ,act4