,,ii  #aad? ,,congress  #a/ ,session    
,s4 #aeji  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #d1 #bjae ,mr4   
,c>p] 7= himself1 ,ms4 ,murk[ski1 ,mr4  
,cassidy1 ,mr4 ,he9ri*1 ,mr4 ,coons1 &  
,mr4 ,grassley7 introduc$ ! foll[+ bill2
 :i* 0 read twice & ref]r$ to !         
,committee on ,f9ance  ,a ,,bill  ,to   
am5d title ,,xviii ( ! ,social ,security
 ,act to provide = ! coord9ation (      
programs to prev5t & treat obesity1 & = 
o!r purposes4  #a4 ,%ort title  ,?is    
,act may be cit$ z ! ,treat & ,r$uce    
,obesity ,act ( #bjae4  #b4 ,f9d+s      
,congress makes ! foll[+ f9d+s3 7#a7    
,accord+ to ! ,c5t]s = ,disease         
,control1 ab\t #cd p]c5t ( adults ag$   
#fe & ov] 7 obese 9 ! p]iod ( #bjji     
?r\gh #bjab1 repres5t+ almo/ #ae million
 p4  7#b7 ,obesity increases ! risk =   
*ronic diseases & conditions1 includ+   
high blood pressure1 he>t disease1 c]ta9
 canc]s1 ar?ritis1 m5tal illness1 lipid 
disord]s1 sleep apnea1 & type #b        
diabetes4  7#c7 ,m ?an half ( ,m$ic>e   

b5efici>ies are treat$ = #e or m *ronic 
conditions p] ye>4 ,! rate ( obesity    
among ,m$ic>e pati5ts d\bl$ f #aihg to  
#bjjb1 & ,m$ic>e sp5d+ on obese         
individuals dur+ t "t m ?an d\bl$4  7#d7
 ,m5 & wom5 ) obesity at age #fe h      
decreas$ life expectancy ( #a4f ye>s =  
m5 & #a4d ye>s = wom54  7#e7 ,! direct &
 indirect co/ ( obesity is m ?an #dej   
billion annually4  7#f7 ,on av]age1 a   
,m$ic>e b5efici>y ) obesity co/s #a1ifd 
m ?an a normal-weight b5efici>y4  7#g7  
,! preval5ce ( obesity among old]       
individuals 9 ! ,unit$ ,/ates is gr[+ at
 a l9e> rate &1 if no?+ *anges1 ne>ly   
half ( ! eld]ly population ( ! ,unit$   
,/ates w h obesity 9 #bjcj accord+ to a 
,congressional ,rese>* ,report on       
obesity4  #c4 ,au?ority to exp& heal?   
c>e provid]s qualifi$ to furni% int5sive
 behavioral !rapy ,section #ahfa7;ddd7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciex7ddd77 is am5d$ by add+ at ! end 
! foll[+ new p>agraph3  7#d7 7,a7       
,subject to subp>agraph 7,b71 !         

,secret>y may1 9 addition to qualifi$   
prim>y c>e physicians & o!r prim>y c>e  
practition]s1 cov] int5sive behavioral  
!rapy = obesity furni%$ by any ( !      
foll[+3  7i7 ,a physician 7z def9$ 9    
subsection 7r77#a77 :o is n a qualifi$  
prim>y c>e physician4  7ii7 ,any o!r    
appropriate heal? c>e provid] 7includ+ a
 physician assi/ant1 nurse practition]1 
or cl9ical nurse speciali/ 7z ^? t]ms   
are def9$ 9 subsection 7aa77#e771 a     
cl9ical psy*ologi/1 a regi/]$ dietitian 
or nutrition pr(essional 7z def9$ 9     
subsection 7vv774  7iii7 ,an            
evid5ce-bas$1 community-bas$ life/yle   
c\nsel+ program approv$ by ! ,secret>y4 
7,b7 ,9 ! case ( int5sive behavioral    
!rapy = obesity furni%$ by a provid]    
describ$ 9 clause 7ii7 or 7iii7 (       
subp>agraph 7,a71 ! ,secret>y may only  
cov] su* !rapy if su* !rapy is furni%$--
  7i7 ^u ref]ral f1 & 9 coord9ation )1 a
 physician or prim>y c>e practition]    
op]at+ 9 a prim>y c>e sett+ or any o!r  
sett+ specifi$ by ! ,secret>y2 &  7ii7 9

 an (fice sett+1 a hospital out-pati5t  
dep>tm5t1 a community-bas$ site t       
complies ) ! ,f$]al regulations conc]n+ 
! privacy ( individually id5tifiable    
heal? in=mation promulgat$ "u section   
#bfd7;c7 ( ! ,heal? ,insurance          
,portability & ,acc\ntability ,act (    
#aiif 7#db ,u4,s4,c4 #acbj;d-#b note71  
or ano!r sett+ specifi$ by ! ,secret>y4 
7,c7 ,9 ord] to ensure a collaborative  
ef=t1 ! coord9ation describ$ 9          
subp>agraph 7,b77i7 %all include ! heal?
 c>e provid] or life/yle c\nsel+ program
 communicat+ to ! ref]r+ physician or   
prim>y c>e practition] any              
recomm5dations or treatm5t plans made   
reg>d+ ! !rapy4  4  #d4 ,m$ic>e "p d    
cov]age ( obesity m$ication  7a7 ,9     
g5]al ,section #ahfj;,d-#b7;e77#b77;,a7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciew-#ajb7;e77#b77;,a77 is  
am5d$ by ins]t+ aft] re/rict$ "u section
 #aibg7;d77#b71 ! foll[+3 o!r ?an       
subp>agraph 7,a7 ( su* section if ! drug
 is us$ = ! treatm5t ( obesity 7z def9$ 

9 section #ahfa7yy77#b77;,c77 or =      
weight loss managem5t = an individual :o
 is ov]weight 7z def9$ 9 section        
#ahfa7yy77#b77;,f77i77 & has "o or m    
relat$ comorbidities14  7b7 ,effective  
date ,! am5dm5t made by subsection 7a7  
%all apply to plan ye>s beg9n+ on or    
aft] ! date t is #b ye>s aft] ! date ( !
 enactm5t ( ?is ,act4  #e4 ,report to   
,congress ,n lat] ?an ! date t is #a ye>
 aft] ! date ( ! enactm5t ( ?is ,act1 & 
e #b ye>s !reaft]1 ! ,secret>y %all     
submit a report to ,congress describ+ ! 
/eps ! ,secret>y has tak5 to implem5t ! 
,act & provide ,congress )              
recomm5dations = bett] coord9ation &    
lev]ag+ ( programs )9 ! ,dep>tm5t (     
,heal? & ,human ,s]vices & o!r ,f$]al   
ag5cies t relate 9 any way to support+  
appropriate rese>* & cl9ical c>e 7su* z 
any int]actions betwe5 physicians & o!r 
heal? c>e provid]s & _! pati5ts7 to     
treat1 r$uce1 & prev5t obesity 9 ! adult
 population4