,,ii  #aafth ,,congress  #ast ,session  
,s4 #bije  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,november #bj1 
#bjai,mr4 ,peters 7for himself and ,mrs4
 ,capito7 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 reduce the occurrence 
of diabetes in ,medicare beneficiaries  
by extending coverage under ,medicare   
for medical nutrition therapy services  
to such beneficiaries with pre-diabetes 
or with risk factors for developing type
 #b diabetes4  #a4 ,short title ,this   
,act may be cited as the ,preventing    
,diabetes in ,medicare ,act of #bjai4   
#b4 ,findings ,congress finds the       
following3  7#a7 ,according to the      
,centers for ,disease ,control and      
,prevention1 there are more than        
#hd1jjj1jjj adults with pre-diabetes in 
the ,united ,states4 ,the ,centers      
estimates that #dh percent of adults who
 are #fe years of age or older have     

pre-diabetes4 ,fewer than #ab percent of
 adults with pre-diabetes have been told
 by a doctor that they have it4  7#b7   
,for a significant number of people with
 pre-diabetes1 early intervention can   
reverse elevated blood glucose levels to
 normal range and prevent diabetes and  
its complications completely or can     
significantly delay its onset4          
,according to the ,institute for        
,alternative ,futures1 if #ej percent of
 adults with pre-diabetes were able to  
successfully make lifestyle changes     
proven to prevent or delay diabetes1    
then by #bjbe approximately #d1gjj1jjj  
new cases of diabetes could be prevented
 at a cost savings of #cjj billion4     
7#c7 ,preventing diabetes and its       
complications can save money and lives4 
,the average annual cost to treat       
someone with diabetes is #af1geb1 which 
is #b4c times higher than average costs 
for someone who does not have diabetes4 
,the ,united ,states spends #cbg billion
 per year on costs associated with      

diabetes1 with government insurance     
including ,medicare covering over #b_/c 
of these costs4  7#d7 ,diabetes is      
unique because its complications and    
their associated health care costs are  
often preventable with currently        
available medical treatment and         
lifestyle changes4  7#e7 ,a recent      
systematic review conducted by the      
,academy of ,nutrition and ,dietetics   
,evidence ,analysis ,library concluded  
that randomized clinical trials         
involving medical nutrition therapy     
resulted in a significant decrease in   
waist circumference1 fasting blood      
glucose1 and two-hour post prandial     
blood glucose1 which is graded as strong
 evidence of having a lower risk of     
developing type #b diabetes4 ,a second1 
independent systematic review of        
diabetes prevention using nutrition     
therapy conducted in ,europe found that 
individuals who received the lifestyle  
interventions had a #dg-percent reduced 
risk of developing type #b diabetes4    

7#f7 ,the ,medicare program currently   
provides coverage for screening and     
identifying beneficiaries with          
pre-diabetes but does not provide       
adequate services to such beneficiaries 
to help them prevent or delay the onset 
of diabetes4  #c4 ,medicare coverage of 
medical nutrition therapy services for  
people with pre-diabetes and risk       
factors for developing type #b diabetes 
7a7 ,in general ,section #ahfa of the   
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7 is amended-- 7#a7 in subsection 
7s77#b77,v71 by striking a beneficiary  
with diabetes or a renal disease and    
inserting an individual with diabetes1  
pre-diabetes 7as defined in subsection  
7yy77#d771 or a renal disease1 or an    
individual at risk for diabetes 7as     
defined in subsection 7yy77#b771 in the 
matter preceding clause 7i72 and  7#b7  
in subsection 7yy7-- 7,a7 in the        
heading1 by adding 2 ,pre-,diabetes at  
the end2 and  7,b7 by adding at the end 
the following new paragraph3  7#d7 ,the 

term pre-diabetes means a condition of  
impaired fasting glucose or impaired    
glucose tolerance identified by a blood 
glucose level that is higher than       
normal1 but not so high as to indicate  
actual diabetes4  4  7b7 ,effective date
 ,the amendments made by this section   
shall apply with respect to services    
furnished on or after ,january #a1      
#bjba4