,,ii  #aac? ,,congress  #a/ ,session    
,s4 #deb  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,m>* #e1 #bjac ,mr4    
,frank5 7= himself1 ,ms4 ,coll9s1 ,mr4  
,rockefell]1 ,mrs4 ,%ahe51 ,mr4 ,br[n1  
,mr4 ,wyd51 ,ms4 ,w>r51 ,ms4 ,klobu*>1  
,mr4 ,blum5?al1 ,mr4 ,c>d91 ,mr4        
,laut5b]g1 & ,mrs4 ,gillibr&7 introduc$ 
! foll[+ bill2 :i* 0 read twice & ref]r$
 to ! ,committee on ,f9ance  ,a ,,bill  
,to am5d title ,,xviii ( ! ,social      
,security ,act to r$uce ! incid5ce (    
diabetes among ,m$ic>e b5efici>ies4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,m$ic>e ,diabetes ,prev5tion ,act (     
#bjac4  #b4 ,diabetes prev5tion "u !    
,m$ic>e program  7a7 ,cov]age ( diabetes
 prev5tion program s]vices  7#a7        
,cov]age ( s]vices  7,a7 ,9 g5]al       
,section #ahfa7s77#b7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciex7s77#b77 is am5d$--  7i7 9        
subp>agraph 7,,ee71 by /rik+ & aft] !   
semicolon at ! end2  7ii7 9 subp>agraph 
7,,ff71 by ins]t+ & aft] ! semicolon at 

! end2 &  7iii7 by add+ at ! end !      
foll[+ new subp>agraph3  7,,gg7 items & 
s]vices furni%$ "u a diabetes prev5tion 
program 7z def9$ 9 subsection 7iii77#a77
 to an eligible diabetes prev5tion      
program individual 7z def9$ 9 subsection
 7iii77#b772  4  7,b7 ,def9itions       
,section #ahfa ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciex7 is am5d$ by 
add+ at ! end ! foll[+ new subsection3  
7iii7 ,diabetes prev5tion program2      
eligible diabetes prev5tion program     
individual2 qualifi$ diabetes prev5tion 
program provid]  7#a7 7,a7 ,! t]m       
diabetes prev5tion program means a      
program t--  7i7 meets ! crit]ia        
describ$ 9 subp>agraph 7,b72 &  7ii7 is 
furni%$ by a qualifi$ diabetes prev5tion
 program provid] 7z def9$ 9 p>agraph    
7#c77;,a774  7,b7 ,! ,secret>y %all     
e/abli% ! crit]ia = a diabetes prev5tion
 program4 ,su* crit]ia %all be 9        
accordance ) ! /&>ds "u ! ,national     
,diabetes ,prev5tion ,program1 z        
e/abli%$ by ! ,c5t]s = ,disease ,control

 & ,prev5tion1 & %all require t !       
program complies ) ! ,f$]al regulations 
7conc]n+ ! privacy ( individually       
id5tifiable heal? in=mation7 promulgat$ 
"u section #bfd7;c7 ( ! ,heal?          
,insurance ,portability & ,acc\ntability
 ,act ( #aiif4 ,9 e/abli%+ su* crit]ia1 
! ,secret>y may also consid] o!r factors
 or cl9ical evid5ce z ! ,secret>y       
det]m9es appropriate4  7,c7 ,items &    
s]vices furni%$ "u a diabetes prev5tion 
program may be furni%$ 9 a community    
sett+1 z def9$ by ! ,secret>y4  7,d7 ,! 
,secret>y %all e/abli% proc$ures "u :i* 
a qualifi$ diabetes prev5tion program   
provid] may contract ) a diabetes       
prev5tion program deliv]y p>tn] to      
furni% ! items & s]vices "u a diabetes  
prev5tion program4 ,= purposes ( ?is    
subsection1 ! t]m diabetes prev5tion    
program deliv]y p>tn] means an entity1  
includ+ non-pr(it organizations1 public 
& private hospitals1 ,/ate & local      
dep>tm5ts ( public heal?1 & ,f$]ally    
qualifi$ heal? c5t]s1 t meets crit]ia   

e/abli%$ by ! ,secret>y4 ,su* crit]ia   
%all be 9 accordance ) ! /&>ds "u !     
,national ,diabetes ,prev5tion ,program1
 z e/abli%$ by ! ,c5t]s = ,disease      
,control & ,prev5tion4 ,9 e/abli%+ su*  
crit]ia1 ! ,secret>y may also consid]   
o!r factors or cl9ical evid5ce z !      
,secret>y det]m9es appropriate4  7#b7   
7,a7 ,! t]m eligible diabetes prev5tion 
program individual means an individual  
at risk = diabetes 7z def9$ 9 subsection
 7yy77#b77 :o w\ld b5efit f items &     
s]vices "u a diabetes prev5tion program1
 z det]m9$ bas$ on crit]ia e/abli%$ by !
 ,secret>y4  7,b7 ,! crit]ia e/abli%$ "u
 subp>agraph 7,a7 %all be 9 accordance )
 ! /&>ds "u ! ,national ,diabetes       
,prev5tion ,program1 z e/abli%$ by !    
,c5t]s = ,disease ,control & ,prev5tion4
 ,9 e/abli%+ su* crit]ia1 ! ,secret>y   
may also consid] o!r factors or cl9ical 
evid5ce z ! ,secret>y det]m9es          
appropriate4  7#c7 7,a7 7i7 ,! t]m      
qualifi$ diabetes prev5tion program     
provid] means any entity1 includ+ a     

,f$]ally qualifi$ heal? c5t]1 t !       
,secret>y det]m9es--  7,i7 is           
appropriate to furni% items & s]vices "u
 a diabetes prev5tion program2 &  7,,ii7
 meets crit]ia e/abli%$ by ! ,secret>y1 
9 consultation ) ! ,c5t]s = ,disease    
,control & ,prev5tion4  7ii7 ,a qualifi$
 diabetes prev5tion program provid] may 
be1 z det]m9$ appropriate by !          
,secret>y1 a suppli] 7z def9$ 9         
subsection 7d771 a provid] ( s]vices 7z 
def9$ 9 subsection 7u771 a heal?        
insurance or s]vices company1 a         
community-bas$ organization1 or any o!r 
appropriate entity4  7,b7 ,a qualifi$   
diabetes prev5tion program provid]      
%all--  7i7 furni% ! items & s]vices "u 
! diabetes prev5tion program ?r\gh a    
deliv]y p>tn] 7pursuant to p>agraph     
7#a77;,d77 unless no su* deliv]y p>tn]  
is available2  7ii7 manage & track !    
outcomes ( a diabetes prev5tion program 
7includ+ att5dance & weight loss (      
p>ticipat+ individuals7 ?r\gh def9$     
sy/ems1 includ+ outcomes ( programs     

furni%$ "u contract ) a diabetes        
prev5tion program deliv]y p>tn] z def9$ 
9 p>agraph 7#a77;,d72  7iii7 implem5t   
bus9ess processes to manage program     
workfl[1 su* z eligibility1 report+1    
claims bill+1 class s*$ul+1 & enrollm5t2
  7iv7 manage & v]ify bill+ accuracy &  
b5efici>y eligibility 7z describ$ 9     
p>agraph 7#b772  7v7 comply ) applicable
 laws & regulations & ensure su*        
compliance by a diabetes prev5tion      
program deliv]y p>tn]2  7vi7 p]=m v>i\s 
=ms ( engagem5t )1 & outrea* to1        
eligible diabetes prev5tion program     
individuals1 includ+ ^? p>ticipat+ 9    
programs furni%$ "u contract ) a        
diabetes prev5tion program deliv]y      
p>tn]2  7vii7 comply ) all program      
integrity requirem5ts z e/abli%$ by !   
,secret>y2 &  7viii7 p]=m su* o!r       
functions z e/abli%$ by ! ,secret>y4  4 
7#b7 ,am\nt ( paym5t ,section           
#ahcc7;a77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciel7a77#a77 is       
am5d$--  7,a7 by /rik+ & 7,z7 & ins]t+  

7,z72 &  7,b7 by ins]t+ be=e ! semicolon
 at ! end ! foll[+3 1 & 7,,aa7 ) respect
 to items & s]vices furni%$ "u a        
diabetes prev5tion program 7z def9$ 9   
section #ahfa7;iii77#a771 ! am\nt paid  
%all be #ajj p]c5t ( 7i7 except z       
provid$ 9 clause 7ii71 ! less] ( !      
actual *>ge = ! items & s]vices or !    
am\nt det]m9$ "u ! fee s*$ule t applies 
to su* items & s]vices "u ?is "p1 z     
det]m9$ by ! ,secret>y1 & 7ii7 9 ! case 
( su* items & s]vices t are cov]$ ,,opd 
s]vices 7z def9$ 9 subsection           
7t77#a77;,b771 ! am\nt det]m9$ "u       
subsection 7t74  7#c7 ,waiv] (          
application ( d$uctible ,! fir/ s5t5ce (
 section #ahcc7;b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciel7b77 is      
am5d$--  7,a7 by /rik+ & be=e 7#aj72 &  
7,b7 by ins]t+ be=e ! p]iod ! foll[+3 1 
& 7#aa7 su* d$uctible %all n apply )    
respect to items & s]vices "u a diabetes
 prev5tion program 7z def9$ 9 section   
#ahfa7;iii77#a774  7#d7 ,assignm5t (    
claims ,section #ahdb7;b77#ah77;,c7 ( ! 

,social ,security ,act 7#db ,u4,s4,c4   
#acieu7b77#ah77;,c77 is am5d$ by add+ at
 ! end ! foll[+ new clause3  7vii7 ,a   
qualifi$ diabetes prev5tion program     
provid] 7z def9$ 9 section              
#ahfa7;iii77#c77;,a774  4  7#e7         
,exclusion ( items & s]vices "u a       
diabetes prev5tion program f skill$     
nurs+ facility prospective paym5t sy/em 
,section #ahhh7;e77#b77;,a77ii7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acieyy7e77#b77;,a77ii77 is am5d$ by    
ins]t+ items & s]vices "u a diabetes    
prev5tion program 7z def9$ 9 section    
#ahfa7;iii77#a771 aft] qualifi$         
psy*ologi/ s]vices14  7#f7 ,inclusion 9 
,f$]ally qualifi$ heal? c5t] s]vices    
,section #ahfa7;aa77#c7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#aciex7aa77#c77 is am5d$--  7,a7 9      
subp>agraph 7,a71 by /rik+ & at ! end2  
7,b7 9 subp>agraph 7,b71 by /rik+ !     
comma at ! end & ins]t+ 2 &2 &  7,c7 by 
add+ aft] subp>agraph 7,b7 ! foll[+ new 
subp>agraph3  7,c7 items & s]vices "u a 

diabetes prev5tion program 7z def9$ 9   
section #ahfa7;iii77#a771  4  7#g7      
,special consid]ation = ! dual eligible 
population ,9 implem5t+ ! am5dm5ts made 
by ?is subsection1 ! ,secret>y ( ,heal? 
& ,human ,s]vices %all give special     
consid]ation to ! ne$s ( individuals :o 
are dually eligible = b5efits "u !      
,m$ic>e & ,m$icaid programs4  7#h7      
,evaluation & report to congress  7,a7  
,evaluation ,! ,secret>y ( ,heal? &     
,human ,s]vices %all conduct an         
evaluation on ! cov]age ( items &       
s]vices "u a diabetes prev5tion program 
"u ! ,m$ic>e program1 z add$ by !       
am5dm5ts made by ?is subsection4 ,su*   
evaluation %all include an analysis (-- 
7i7 ! impact ( ! provision ( su* cov]age
 on ,m$ic>e b5efici>ies1 includ+ !      
impact on v>i\s populations1 su* z      
individuals :o are dually eligible =    
b5efits "u ! ,m$ic>e & ,m$icaid         
programs1 & ! impact ( ! provision ( su*
 cov]age on heal? disp>ities2  7ii7 !   
rate at :i* physicians ref] eligible    

diabetes prev5tion program individuals  
to diabetes prev5tion programs "u !     
,m$ic>e program2  7iii7 ,m$ic>e         
b5efici>y p>ticipation levels 9 diabetes
 prev5tion programs "u ! ,m$ic>e program
 & ! aw>5ess ( ,m$ic>e b5efici>ies ( !  
b5efit2  7iv7 ! heal? outcomes result+ f
 completion ( a diabetes prev5tion      
program "u ! ,m$ic>e program2  7v7      
program integrity protections important 
to diabetes prev5tion programs "u !     
,m$ic>e program2 &  7vi7 o!r areas      
det]m9$ appropriate by ! ,secret>y4     
7,b7 ,report ,n lat] ?an ,janu>y #a1    
#bjai1 ! ,secret>y ( ,heal? & ,human    
,s]vices %all submit to ,congress a     
report on ! evaluation conduct$ "u      
subp>agraph 7,a71 toge!r )              
recomm5dations = su* legislation &      
adm9i/rative actions z ! ,secret>y      
det]m9es appropriate4  7#i7 ,effective  
date ,! am5dm5ts made by p>agraphs 7#a7 
?r\gh 7#f7 %all apply ) respect to      
s]vices furni%$ on or aft] ,janu>y #a1  
#bjae4  7b7 ,inclusion ( ref]ral rates  

to diabetes prev5tion programs 9 !      
m$ic>e physician quality report+ sy/em  
,section #ahdh7k77#b77;,c77i7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7k77#b77;,c77i77 is am5d$ by   
add+ at ! end ! foll[+ new s5t5ce3 ,=   
purposes ( report+ data on quality      
measures = cov]$ pr(essional s]vices    
furni%$ dur+ #bjah & ea* subsequ5t ye>1 
! quality measures specifi$ "u ?is      
p>agraph %all include a measure )       
respect to ref]rals ( eligible diabetes 
prev5tion program individuals 7z def9$ 9
 p>agraph 7#b7 ( section #ahfa7;iii77 to
 diabetes prev5tion programs 7z def9$ 9 
p>agraph 7#a7 ( su* section744  7c7     
,inclusion ( diabetes risk assessm5t 9  
m$ic>e p]sonaliz$ prev5tion plan  7#a7  
,9 g5]al ,section #ahfa7;hhh77#b77;,c7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciex7hhh77#b77;,c77 is am5d$ by      
ins]t+ be=e ! p]iod at ! end ! foll[+3 1
 & an assessm5t ( :e!r ! individual is  
an individual at risk = diabetes 7z     
def9$ 9 subsection 7yy77#b774  7#b7     

,effective date ,! am5dm5ts made by ?is 
subsection %all apply to p]sonaliz$     
prev5tion plans creat$ or updat$ on or  
aft] ,janu>y #a1 #bjae4  #c4 ,f9d+s2    
s5se ( ! ,s5ate reg>d+ diabetes         
prev5tion "u ! ,m$icaid program  7a7    
,f9d+s ,congress makes ! foll[+ f9d+s3  
7#a7 ,! preval5ce & co/ ( diabetes is a 
significant conc]n = ,/ate ,m$icaid     
programs4 ,by #bjba1 ! ,m$icaid program 
is expect$ to cov] #ac1jjj1jjj p )      
diabetes & ab\t #i1jjj1jjj p :o may h   
pre-diabetes4 ,by #bjba1 ,/ates w sp5d  
an e/imat$ #hc1jjj1jjj1jjj on           
individuals ) diabetes or pre-diabetes4 
7#b7 ,! ,national ,diabetes ,prev5tion  
,program1 z e/abli%$ by ! ,c5t]s =      
,disease ,control & ,prev5tion1 has be5 
prov5 to r$uce ! onset ( diabetes 9     
at-risk adults by #eh p]c5t1 us+ a      
co/-effective1 community-bas$           
int]v5tion4  7b7 ,s5se ( ! ,s5ate ,x is 
! s5se ( ! ,s5ate t ! ,national         
,diabetes ,prev5tion ,program pres5ts an
 opportunity = ,/ates to r$uce !        

incid5ce ( diabetes among individuals   
enroll$ 9 _! ,m$icaid programs4