,,ii  #aac? ,,congress  #a/ ,session    
,s4 #ide  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,may #ad1 #bjac ,mrs4  
,%ahe5 7= h]self1 ,ms4 ,coll9s1 ,mr4    
,begi*1 ,mrs4 ,hagan1 & ,mr4 ,frank57   
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
improve access to diabetes              
self-managem5t tra9+ by au?oriz+ c]tifi$
 diabetes educators to provide diabetes 
self-managem5t tra9+ s]vices1 includ+ z 
"p ( teleheal? s]vices1 "u "p ,b ( !    
,m$ic>e program4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,access to ,quality
 ,diabetes ,education ,act ( #bjac4  #b4
 ,f9d+s ,congress makes ! foll[+ f9d+s3 
7#a7 ,! ,c5t]s = ,disease ,control &    
,prev5tion 7h]e9aft] ,,cdc7 report t    
ne>ly #bf1jjj1jjj ,am]icans h diabetes1 
9 addition to an e/imat$ #gi1jjj1jjj    
,am]icans :o h pr$iabetes1 an increase (
 #bd1jjj1jjj ,am]icans ) ei!r diabetes  
or pr$iabetes s9ce #bjjh4 ,p )          

pr$iabetes are at increas$ risk (       
develop+ ,type #b diabetes or           
c>diovascul> disease4  7#b7 ,diabetes   
impacts #h4c p]c5t ( all ,am]icans &    
#aa4c p]c5t ( ,am]ican adults4 ,! ,,cdc 
e/imates t z _m z #a 9 #c ,am]icans w h 
diabetes by #bjej if curr5t tr5ds       
cont9ue4  7#c7 ,accord+ to ! ,am]ican   
,diabetes ,association1 ! total co/s (  
diagnos$ diabetes h ris5 to #bde billion
 9 #bjab f #agd billion 9 #bjjg1 :5 !   
co/ 0 la/ exam9$ by ! ,,cdc4 ,?is figure
 repres5ts a #da p]c5t increase ov] a   
five-ye> p]iod4  7#d7 ,"o 9 #c ,m$ic>e  
doll>s is curr5tly sp5t on p ) diabetes4
  7#e7 ,!re 7 #aa4c million diabetes    
relat$ em]g5cy room visits 9 #bjjh1     
comp>$ ) #i4e million 9 #bjjj1 an       
increase ( #aa p]c5t4  7#f7 ,accord+ to 
! ,,cdc1 heal? c>e provid]s are f9d+    
/ati/ically significant increases 9 !   
preval5ce ( ,type #b diabetes 9 *ildr5 &
 adolesc5ts4  7#g7 ,diabetes            
self-managem5t tra9+ 7h]e9aft] ,,dsmt71 
also call$ diabetes education1 provides 

critical k & skills tra9+ to pati5ts )  
diabetes1 help+ !m manage m$ications1   
address nutritional issues1 facilitate  
diabetes-relat$ problem solv+1 & make   
o!r critical life/yle *anges to         
effectively manage _! diabetes4 ,evid5ce
 %[s t individuals p>ticipat+ 9 ,,dsmt  
programs are able to progress along !   
cont9uum necess>y to make su/a9$        
behavioral *anges 9 ord] to manage _!   
diabetes4  7#h7 ,a c]tifi$ diabetes     
educator is a ,/ate lic5s$ or regi/]$   
heal? c>e pr(essional :o specializes 9  
help+ p ) diabetes develop !            
self-managem5t skills ne$$ to /ay heal?y
 & avoid co/ly acute complications &    
em]g5cy c>e1 z well z debilitat+        
second>y conditions caus$ by diabetes4  
7#i7 ,diabetes self-managem5t tra9+ has 
be5 prov5 effective 9 help+ to r$uce !  
risks & complications ( diabetes & is a 
vital compon5t ( an ov]all diabetes     
treatm5t regim54 ,pati5ts :o h receiv$  
tra9+ f a c]tifi$ diabetes educator are 
bett] able to implem5t ! treatm5t plan  

receiv$ f a physician skill$ 9 diabetes 
treatm5t4  7#aj7 ,life/yle *anges1 su* z
 ^? taught by c]tifi$ diabetes          
educators1 directly contribute to bett] 
glycemic control & r$uc$ complications f
 diabetes4 ,evid5ce %[s t ! pot5tial =  
prev5tion ( ! mo/ s]i\s m$ical          
complications caus$ by diabetes to be z 
high z #ij p]c5t 7bl9dness71 #he p]c5t  
7amputations71 & #ej p]c5t 7he>t disease
 & /roke7 ) prop] m$ical treatm5t &     
active self-managem5t4  7#aa7 ,9        
recognition ( ! important role ( ,,dsmt 
programs1 ! ,,cdc 9 #bjab aw>d$ fund+ to
 exp& ! ,national ,diabetes ,prev5tion  
,program to help prev5t ! onset ( ,type 
#b diabetes = individuals at high risk4 
7#ab7 ,! net sav+s to ! ,m$ic>e program 
( ensur+ t b5efici>ies h access to      
quality ,,dsmt is e/imat$ to be         
#b1jjj1jjj1jjj ov] #aj ye>s4  7#ac7     
,despite its effectiv5ess 9 r$uc+       
diabetes-relat$ complications &         
associat$ co/s1 diabetes self-managem5t 
tra9+ has be5 recogniz$ by ! ,c5t]s =   

,m$ic>e  ,m$icaid ,s]vices z an         
und]utiliz$ ,m$ic>e b5efit1 ev5 aft] m  
?an a decade ( cov]age4  7#ad7 ,enhanc+ 
access to diabetes self-managem5t tra9+ 
programs t are c]tifi$ z necess>y by !  
pati5t's treat+ physician & taught by   
c]tifi$ diabetes educators is an        
important public policy goal t c help   
improve heal? outcomes1 ensure quality1 
& r$uce escalat+ diabetes-relat$ heal?  
co/s4  #c4 ,recognition ( c]tifi$       
diabetes educators z au?oriz$ provid]s (
 ,m$ic>e diabetes outpati5t             
self-managem5t tra9+ s]vices  7a7 ,9    
g5]al ,section #ahfa7qq7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#aciex7qq77 is am5d$--  7#a7 9 p>agraph 
7#a71 by /rik+ by a c]tifi$ provid] 7z  
describ$ 9 p>agraph 7#b77;,a77 9 an     
outpati5t sett+ & ins]t+ 9 an outpati5t 
sett+ by a c]tifi$ diabetes educator 7z 
def9$ 9 p>agraph 7#c77 or by a c]tifi$  
provid] 7z describ$ 9 p>agraph          
7#b77;,a772 &  7#b7 by add+ at ! end !  
foll[+ new p>agraphs3  7#c7 ,= purposes 

( p>agraph 7#a71 ! t]m c]tifi$ diabetes 
educator means an individual--  7,a7 :o 
is lic5s$ or regi/]$ by ! ,/ate 9 :i* ! 
s]vices are p]=m$ z a c]tifi$ diabetes  
educator2 or  7,b7 :o--  7i7 is lic5s$  
or regi/]$ by ! ,/ate 9 :i* ! s]vices   
are p]=m$ z a heal? c>e pr(essional2    
7ii7 specializes 9 tea*+ individuals )  
diabetes to develop ! necess>y skills & 
k to manage ! individual's diabetic     
condition2 &  7iii7 is c]tifi$ z a      
diabetes educator by a recogniz$ c]tify+
 body 7z def9$ 9 p>agraph 7#d774  7#d7  
,= purposes ( p>agraph 7#c77;,b77iii71 !
 t]m recogniz$ c]tify+ body means a     
c]tify+ body = diabetes educators :i* is
 recogniz$ by ! ,secret>y z au?oriz$ to 
grant c]tification ( diabetes educators 
= purposes ( ?is subsection pursuant to 
/&>ds e/abli%$ by ! ,secret>y4  4  7b7  
,treatm5t z a practition]1 includ+ =    
teleheal? s]vices ,section              
#ahdb7;b77#ah77;,c7 ( ! su* ,act 7#db   
,u4,s4,c4 #acieu7b77#ah77;,c77 is am5d$ 
by add+ at ! end ! foll[+ new clause3   

7vii7 ,a c]tifi$ diabetes educator 7z   
def9$ 9 section #ahfa7qq77#c774  4  7c7 
,,gao /udy & report  7#a7 ,/udy ,!      
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all conduct a /udy to id5tify ! b>ri]s 
t exi/ = ,m$ic>e b5efici>ies ) diabetes 
9 access+ diabetes self-managem5t tra9+ 
s]vices "u ! ,m$ic>e program1 includ+   
economic & geographic b>ri]s &          
availability ( appropriate ref]rals &   
access to adequate & qualifi$ provid]s4 
7#b7 ,report ,n lat] ?an #a ye> aft] !  
date ( ! enactm5t ( ?is ,act1 !         
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all submit to ,congress a report on !  
/udy conduct$ "u p>agraph 7#a74  7d7    
,,ahrq developm5t ( recomm5dations =    
outrea* me?ods & report  7#a7           
,developm5t ( recomm5dations ,!         
,director ( ! ,ag5cy = ,heal?c>e ,rese>*
 & ,quality %all1 ?r\gh use ( a work%op 
& o!r appropriate means1 develop a s]ies
 ( recomm5dations on effective outrea*  
me?ods to educate physicians & o!r heal?
 c>e provid]s z well z ! public ab\t !  

b5efits ( diabetes self-managem5t tra9+ 
9 ord] to promote bett] heal? outcomes =
 pati5ts ) diabetes4  7#b7 ,report ,n   
lat] ?an #a ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 ! ,director ( ! ,ag5cy =   
,heal?c>e ,rese>* & ,quality %all submit
 to ,congress a report on !             
recomm5dations develop$ "u p>agraph     
7#a74  7e7 ,effective date ,! am5dm5ts  
made by ?is section %all apply to items 
& s]vices furni%$ aft] ! end ( !        
#ab-mon? p]iod beg9n+ on ! date ( !     
enactm5t ( ?is ,act4