,,ii #aacth ,,congress #ast ,session ,s4 #ide ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ad1 #bjac ,mrs4 ,shaheen 7for herself1 ,ms4 ,collins1 ,mr4 ,begich1 ,mrs4 ,hagan1 and ,mr4 ,franken7 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 improve access to diabetes self-management training by authorizing certified diabetes educators to provide diabetes self-management training services1 including as part of telehealth services1 under part ,b of the ,medicare program4 #a4 ,short title ,this ,act may be cited as the ,access to ,quality ,diabetes ,education ,act of #bjac4 #b4 ,findings ,congress makes the following findings3 7#a7 ,the ,centers for ,disease ,control and ,prevention 7hereinafter ,,cdc7 report that nearly #bf1jjj1jjj ,americans have diabetes1 in addition to an estimated #gi1jjj1jjj ,americans who have prediabetes1 an increase of #bd1jjj1jjj ,americans with either diabetes or prediabetes since #bjjh4 ,people with prediabetes are at increased risk of developing ,type #b diabetes or cardiovascular disease4 7#b7 ,diabetes impacts #h4c percent of all ,americans and #aa4c percent of ,american adults4 ,the ,,cdc estimates that as many as #a in #c ,americans will have diabetes by #bjej if current trends continue4 7#c7 ,according to the ,american ,diabetes ,association1 the total costs of diagnosed diabetes have risen to #bde billion in #bjab from #agd billion in #bjjg1 when the cost was last examined by the ,,cdc4 ,this figure represents a #da percent increase over a five-year period4 7#d7 ,one in #c ,medicare dollars is currently spent on people with diabetes4 7#e7 ,there were #aa4c million diabetes related emergency room visits in #bjjh1 compared with #i4e million in #bjjj1 an increase of #aa percent4 7#f7 ,according to the ,,cdc1 health care providers are finding statistically significant increases in the prevalence of ,type #b diabetes in children and adolescents4 7#g7 ,diabetes self-management training 7hereinafter ,,dsmt71 also called diabetes education1 provides critical knowledge and skills training to patients with diabetes1 helping them manage medications1 address nutritional issues1 facilitate diabetes-related problem solving1 and make other critical lifestyle changes to effectively manage their diabetes4 ,evidence shows that individuals participating in ,,dsmt programs are able to progress along the continuum necessary to make sustained behavioral changes in order to manage their diabetes4 7#h7 ,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 care1 as well as debilitating secondary conditions caused by diabetes4 7#i7 ,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 regimen4 ,patients who have received training from a certified diabetes educator are better able to implement the treatment plan received from a physician skilled in diabetes treatment4 7#aj7 ,lifestyle changes1 such as those taught by certified diabetes educators1 directly contribute to better glycemic control and reduced complications from diabetes4 ,evidence shows that the potential for prevention of the most serious medical complications caused by diabetes to be as high as #ij percent 7blindness71 #he percent 7amputations71 and #ej percent 7heart disease and stroke7 with proper medical treatment and active self-management4 7#aa7 ,in recognition of the important role of ,,dsmt programs1 the ,,cdc in #bjab awarded funding to expand the ,national ,diabetes ,prevention ,program to help prevent the onset of ,type #b diabetes for individuals at high risk4 7#ab7 ,the net savings to the ,medicare program of ensuring that beneficiaries have access to quality ,,dsmt is estimated to be #b1jjj1jjj1jjj over #aj years4 7#ac7 ,despite its effectiveness in reducing diabetes-related complications and associated costs1 diabetes self-management training has been recognized by the ,centers for ,medicare ,medicaid ,services as an underutilized ,medicare benefit1 even after more than a decade of coverage4 7#ad7 ,enhancing access to diabetes self-management training programs that are certified as necessary by the patient's treating physician and taught by certified diabetes educators is an important public policy goal that can help improve health outcomes1 ensure quality1 and reduce escalating diabetes-related health costs4 #c4 ,recognition of certified diabetes educators as authorized providers of ,medicare diabetes outpatient self-management training services 7a7 ,in general ,section #ahfa7qq7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7qq77 is amended-- 7#a7 in paragraph 7#a71 by striking by a certified provider 7as described in paragraph 7#b77;,a77 in an outpatient setting and inserting in an outpatient setting by a certified diabetes educator 7as defined in paragraph 7#c77 or by a certified provider 7as described in paragraph 7#b77;,a772 and 7#b7 by adding at the end the following new paragraphs3 7#c7 ,for purposes of paragraph 7#a71 the term certified diabetes educator means an individual-- 7,a7 who is licensed or registered by the ,state in which the services are performed as a certified diabetes educator2 or 7,b7 who-- 7i7 is licensed or registered by the ,state in which the services are performed as a health care professional2 7ii7 specializes in teaching individuals with diabetes to develop the necessary skills and knowledge to manage the individual's diabetic condition2 and 7iii7 is certified as a diabetes educator by a recognized certifying body 7as defined in paragraph 7#d774 7#d7 ,for purposes of paragraph 7#c77;,b77iii71 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 ,secretary4 4 7b7 ,treatment as a practitioner1 including for telehealth services ,section #ahdb7;b77#ah77;,c7 of the such ,act 7#db ,u4,s4,c4 #acieu7b77#ah77;,c77 is amended by adding at the end the following new clause3 7vii7 ,a certified diabetes educator 7as defined in section #ahfa7qq77#c774 4 7c7 ,,gao study and report 7#a7 ,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 program1 including economic and geographic barriers and availability of appropriate referrals and access to adequate and qualified providers4 7#b7 ,report ,not later than #a year after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on the study conducted under paragraph 7#a74 7d7 ,,ahrq development of recommendations for outreach methods and report 7#a7 ,development of recommendations ,the ,director of the ,agency for ,healthcare ,research and ,quality shall1 through use of a workshop and other appropriate means1 develop a series of recommendations on effective outreach methods to educate physicians and other health care providers as well as the public about the benefits of diabetes self-management training in order to promote better health outcomes for patients with diabetes4 7#b7 ,report ,not later than #a year after the date of the enactment of this ,act1 the ,director of the ,agency for ,healthcare ,research and ,quality shall submit to ,congress a report on the recommendations developed under paragraph 7#a74 7e7 ,effective date ,the amendments made by this section shall apply to items and services furnished after the end of the #ab-month period beginning on the date of the enactment of this ,act4