,i #aafth ,,congress #b;d ,session ,h4 ,r4 #hfeh ,,in ,,the ,,house ,,of ,,representatives ,october #bc1 #bjbj,mr4 ,crenshaw 7for himself and ,mr4 ,ruiz7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to establish a ,federal strategy for preventing1 diagnosing1 and treating nonalcoholic steatohepatitis1 commonly referred to as ,,nash4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,nonalcoholic ,steatohepatitis ,care ,act of #bjbj or the ,,nash ,care ,act of #bjbj4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,sec4 #b4 ,national prevention program for diabetes1 nonalcoholic fatty liver disease1 and metabolic syndrome4,sec4 #c4 ,grants for community-based patient education and provider training and outreach4,sec4 #d4 ,national ,academies of ,sciences study on education and policy needs for nonalcoholic steatohepatitis and nonalcoholic fatty liver disease4,sec4 #e4 ,national surveillance program for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis4,sec4 #f4 ,recommendations for the prevention1 screening1 diagnosis1 and treatment of interrelated conditions developed by multidisciplinary task force4,sec4 #g4 ,renaming of ,,nih institute to reflect liver diseases and creation of division of liver diseases4 #b4 ,national prevention program for diabetes1 nonalcoholic fatty liver disease1 and metabolic syndrome ,section #cii,v-#c of the ,public ,health ,service ,act 7#bhj;g-#ad7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by inserting or continue after establish2 7,b7 by striking national diabetes2 7,c7 by inserting 1 nonalcoholic fatty liver disease1 and metabolic syndrome after high risk for diabetes2 and 7,d7 by striking burden of diabetes and inserting such conditions2 7#b7 in subsection 7b7-- 7,a7 by striking paragraph 7#a7 7,b7 by redesignating paragraphs 7#b7 through 7#d7 as paragraphs 7#c7 through 7#e72 and 7,c7 by inserting before paragraph 7#c7 7as so redesignated7 the following2 7#a7 competitive grants to eligible entities for the purposes of identifying1 developing1 or disseminating best practices on the prevention1 detection1 and treatment of diabetes1 nonalcoholic fatty liver disease1 and metabolic syndrome2 7#b7 competitive grants for eligible entities for the development of community-based prevention program model sites2 2 7#c7 by redesignating subsection 7d7 as subsection 7e72 7#d7 by inserting after subsection 7c7 the following3 7d7 ,preference ,in awarding grants under subsection 7b71 the ,secretary may give preference to eligible entities that-- 7#a7 provide lifestyle interventions1 including nutrition and exercise consultation2 and 7#b7 serve racial and ethnic minority communities with high rates of diabetes1 nonalcoholic fatty liver disease1 and metabolic syndrome4 2 and 7#e7 in subsection 7e7 7as redesignated by paragraph 7#c771 by striking such sums as may be necessary for each of fiscal years #bjaj through #bjad and inserting #bg1cjj1jjj for each of fiscal years #bjba through #bjbe4 #c4 ,grants for community-based patient education and provider training and outreach 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall establish a grant program under which the ,secretary may award grants to eligible entities to provide education in the prevention of nonalcoholic steatohepatitis 7referred to in this ,act as ,,nash71 which shall be know as the ,national ,,nash ,prevention and ,education ,program 7referred to in this section as the ,program74 ,to the extent practicable1 the ,secretary shall align such program with the eligibility criteria to receive grants under the ,national ,diabetes ,prevention ,program of the ,centers for ,disease ,control and ,prevention4 7b7 ,eligible entities ,an entity is eligible to received a grant under the ,program if such entity-- 7#a7 7,a7 provides lifestyle interventions such as promotion of liver health interventions or nutrition and exercise consultation2 or 7,b7 serves racial and ethnic minority communities with high rates of nonalcoholic fatty liver disease 7as determined by ,secretary72 and 7#b7 is a community-based1 nonprofit organization located in any state or is an experienced organization in developing liver health education and awareness programs4 7c7 ,application ,an eligible entity seeking a grant under this section shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7d7 ,term ,the term of a grant awarded under this section shall not exceed #e years4 7e7 ,curriculum development 7#a7 ,in general ,the ,secretary shall develop1 taking into consideration the best practices developed by grantees under section #cii,v-#c7;b77#a7 of the ,public ,health ,service ,act1 as amended by section #b of this ,act1 directly or through grants to eligible entities1 a curriculum to provide education in ,,nash prevention for use by recipients of grants under this section4 7#b7 ,focus areas ,the curriculum shall provide for consistency in-- 7,a7 application of screening and diagnostic recommendations2 7,b7 collection of population data and quality measures2 and 7,c7 delivery of recommended evidence-based lifestyle interventions specific to nutrition and exercise4 7f7 ,populations considered ,in carrying out this section1 the ,secretary shall consider the needs of pediatric and minority populations at risk for ,,nash4 7g7 ,coordination with continuing medical education ,the task force established under section #f shall1 to the extent practicable1 coordinate the availability of training and outreach under this subsection with the opportunity for providers receiving training pursuant to this section to earn continuing medical education credits4 7h7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years #bjba through #bjbe4 #d4 ,national ,academies of ,sciences study on education and policy needs for nonalcoholic steatohepatitis and nonalcoholic fatty liver disease 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall offer to enter into a contract with the ,national ,academies of ,sciences to conduct a study on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in the ,united ,states4 7b7 ,focus areas ,the study conducted pursuant to subsection 7a7 shall focus on education and policy needs involving nonalcoholic fatty liver disease and nonalcoholic steatohepatitis1 including-- 7#a7 opportunities to strengthen prevention of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis1 including through enhanced delivery of nutrition services2 7#b7 barriers to diagnosis and treatment of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis1 including opportunities to strengthen coverage under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 the ,medicaid program under title ,,xix of such ,act 7#db ,u4,s4,c4 #acif et seq471 group health plans 7as defined in section #bgia of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ia771 and group or individual health insurance coverage 7as such terms are defined in such section #bgia72 7#c7 recommendations for enhancing provider education on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis2 and 7#d7 recommendations for enhancing patient awareness of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis1 including early identification of risk factors and linkage to appropriate care4 7c7 ,report ,the agreement entered into under subsection 7a7 shall require the ,national ,academies of ,sciences to1 not later than ,january #a1 #bjbb1 submit a report on the findings of the study to the ,secretary and the ,chairman and ,ranking ,member of each of the following committees3 7#a7 ,the ,committee on ,energy and ,commerce of the ,house of ,representatives4 7#b7 ,the ,committee on ,ways and ,means of the ,house of ,representatives4 7#c7 ,the ,committee on ,finance of the ,senate4 7#d7 ,the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate4 7d7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #a1jjj1jjj for each of fiscal years #bjba and #bjbb4 #e4 ,national surveillance program for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis 7a7 ,in general ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall establish a program to provide for surveillance on the prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in the ,united ,states4 7b7 ,program activities 7#a7 ,surveillance activities ,the program established under subsection 7a7 shall include1 at a minimum1 each of the following surveillance activities3 7,a7 ,conducting local surveillance activities to collect data on the prevalence and severity of nonalcoholic fatty level disease and nonalcoholic steatohepatitis4 7,b7 ,compiling and annually publishing data on the number of individuals with nonalcoholic fatty level disease and nonalcoholic steatohepatitis nationally as well as in each state4 7,c7 ,to the extent practicable1 providing data on the general population at risk of developing the conditions4 7#b7 ,technical assistance on vital statistics ,in carrying out the program under subsection 7a71 the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall issue guidance that provides technical assistance to health care providers and ,state and local health departments on best practices to ensure appropriate collection of vital statistics for purposes of birth and death certificates1 including vital statistics on populations with nonalcoholic fatty level disease and nonalcoholic steatohepatitis4 7c7 ,authorization of appropriations ,there are authorized to be appropriated-- 7#a7 to carry out surveillance activities described in subsection 7b77#a71 #aj1jjj1jjj for each of fiscal years #bjba and #bjbb2 7#b7 to carry out technical assistance activities described in subsection 7b77#c71 #aj1jjj1jjj for each of fiscal years #bjba and #bjbb2 and 7#c7 to carry out the activities described in subsection 7b77#b71 #e1jjj1jjj for each of fiscal years #bjba through #bjbe4 #f4 ,recommendations for the prevention1 screening1 diagnosis1 and treatment of interrelated conditions developed by multidisciplinary task force 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,health and ,human ,services shall establish a multidisciplinary task force1 and appoint members to such task force1 to develop recommendations for the prevention1 screening1 diagnosis1 and treatment for several interrelated conditions1 including1 at a minimum-- 7#a7 nonalcoholic fatty liver disease2 7#b7 nonalcoholic steatohepatitis2 7#c7 obesity2 7#d7 diabetes and other metabolic disorders2 and 7#e7 any other conditions determined appropriate by the ,secretary4 7b7 ,membership ,the task force established under subsection 7a7 shall be composed of not more than #ab members to be appointed by the ,secretary and shall include representatives of each of the following groups3 7#a7 ,physician specialists1 including in hepatology1 gastroenterology1 endocrinology1 cardiology1 and endocrinology4 7#b7 ,experts in public health and epidemiology4 7#c7 ,patient advocates4 7#d7 ,non-voting representatives of ,federal agencies1 including the ,food and ,drug ,administration1 the ,national ,institutes of ,health1 the ,centers for ,disease ,control and ,prevention1 and the ,office of the ,assistant ,secretary for ,health of the ,department of ,health and ,human ,services4 7#e7 ,non-voting representatives of manufacturers of drugs1 devices1 or diagnostic tools approved by the ,food and ,drug ,administration for the treatment of any of the conditions specified in subsection 7a74 7c7 ,development of recommendations ,in developing the recommendations under subsection 7a71 the task force established under such subsection shall consider-- 7#a7 guidelines issued by the ,american ,association for the ,study of ,liver ,diseases1 published evidence1 recommendations of the ,united ,states ,preventive ,services ,task ,force1 and other information it determines appropriate in developing such recommendations2 and 7#b7 whether a combined protocol addressing a range of conditions specified in such subsection is advised for populations affected by more than one condition for which such recommendations are being developed4 7d7 ,deadline for compiling recommendations ,the task force shall compile screening and diagnosis recommendations developed under subsection 7a7 not later than #ah months after the date on which the first meeting of the task force concludes4 7e7 ,public health action plan 7#a7 ,in general ,not later than #a year after the date of the enactment of this ,act1 the task force shall develop an action plan to combat nonalcoholic steatohepatitis 7referred to in this section as the ,action ,plan74 7#b7 ,issues addressed ,the ,action ,plan shall identify key goals and implementation strategies for-- 7,a7 assuring appropriate surveillance of the public health impact in the ,united ,states of nonalcoholic steatohepatitis2 7,b7 increasing awareness among the general public of the ,united ,states of risk factors2 7,c7 enhancing clinical education on the prevention1 diagnosis1 and treatment of nonalcoholic steatohepatitis among physicians and health care professionals within the ,united ,states2 7,d7 supporting research on therapies and cures for nonalcoholic steatohepatitis2 and 7,e7 other areas determined appropriate by the ,secretary4 7#c7 ,evaluation and report 7,a7 ,evaluation ,the ,secretary shall1 at least every #b years1 evaluate the implementation of the ,action ,plan under this section to provide any updates or modifications to such plan4 7,b7 ,report ,not later than #ah months after the date on which the ,action ,plan developed under paragraph 7#a7 is released1 the ,secretary shall submit to ,congress a report that discusses any updated recommendations for updates or modifications considering initial progress made in advancing the action plan's goals or barriers to attaining such goals4 7f7 ,report regarding liver cancer ,not later than #a year after the date on which the first meeting of the working group is held1 the working group shall transmit to the ,director of the ,,nih a report providing recommendations with respect to preventive and diagnostic measures that could1 in consideration of the relationship between the prevalence of liver cancer and the prevalence of certain liver diseases1 help reduce liver cancer rates and make liver cancer more treatable when detected4 #g4 ,renaming of ,,nih institute to reflect liver diseases and creation of division of liver diseases 7a7 ,institute renamed ,effective on ,january #a1 #bjba1 title ,,iv of the ,public ,health ,service ,act is amended by striking ,national ,institute for ,diabetes and ,digestive and ,kidney ,diseases each place it appears in section #dja7;b7 7#db ,u4,s4,c4 #bha7;b771 in section #dji;,a7a7 7#db ,u4,s4,c4 #bhd;a7a771 in the heading of subpart #c of part ,c1 in section #dbf 7#db ,u4,s4,c4 #bhe;c71 and section #dcj 7#db ,u4,s4,c4 #bhe;c-#d7 and inserting ,the ,national ,institute of ,diabetes and ,digestive1 ,kidney1 and ,liver ,diseases4 7b7 ,conforming changes ,effective on ,january #a1 #bjba1 any reference to the ,national ,institute for ,diabetes and ,digestive and ,kidney ,diseases in any law1 regulation1 document1 record1 or other paper of the ,united ,states shall be deemed to be a reference to the ,national ,institute of ,diabetes and ,digestive1 ,kidney1 and ,liver ,diseases4 7c7 ,establishment of ,division for ,liver ,diseases 7#a7 ,in general ,section #dbh of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhe;c-#b7 is amended-- 7,a7 in subsection 7a77#a7-- 7i7 in the matter preceding subparagraph 7,a71 by inserting a ,division ,director for ,liver ,diseases1 after and ,nutrition12 and 7ii7 in subparagraph 7,a71 by inserting liver diseases1 after and nutrition12 and 7,b7 in subsection 7b7-- 7i7 in the matter preceding paragraph 7#a71 by inserting the ,division ,director for ,liver ,diseases1 after and ,nutrition12 and 7ii7 in paragraph 7#a71 by inserting liver diseases1 after and nutritional disorders14 7#b7 ,transfer of authority ,effective on ,january #a1 #bjba1 the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,national ,institutes of ,health1 shall transfer to the ,division ,director of ,liver ,diseases of the ,national ,institute of ,diabetes and ,digestive1 ,kidney1 and ,liver ,diseases1 the authorities 7including all budget authorities1 available appropriations1 and personnel71 duties1 obligations1 and related legal and administrative functions prescribed by law or otherwise previously granted to the ,liver ,disease ,research ,branch within the ,division of ,digestive ,diseases and ,nutrition of the ,national ,institute for ,diabetes and ,digestive and ,kidney ,diseases4