,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #bije  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,novemb] #bj1 #bjai,mr4
 ,pet]s 7= himself & ,mrs4 ,capito7     
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
r$uce ! occurr5ce ( diabetes 9 ,m$ic>e  
b5efici>ies by ext5d+ cov]age "u ,m$ic>e
 = m$ical nutrition !rapy s]vices to su*
 b5efici>ies ) pre-diabetes or ) risk   
factors = develop+ type #b diabetes4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,prev5t+ ,diabetes 9 ,m$ic>e ,act (   
#bjai4  #b4 ,f9d+s ,congress f9ds !     
foll[+3  7#a7 ,accord+ to ! ,c5t]s =    
,disease ,control & ,prev5tion1 !re are 
m ?an #hd1jjj1jjj adults ) pre-diabetes 
9 ! ,unit$ ,/ates4 ,! ,c5t]s e/imates t 
#dh p]c5t ( adults :o are #fe ye>s ( age
 or old] h pre-diabetes4 ,few] ?an #ab  
p]c5t ( adults ) pre-diabetes h be5 told
 by a doctor t !y h x4  7#b7 ,= a       
significant numb] ( p ) pre-diabetes1   

e>ly int]v5tion c rev]se elevat$ blood  
glucose levels to normal range & prev5t 
diabetes & its complications completely 
or c significantly delay its onset4     
,accord+ to ! ,in/itute = ,alt]native   
,futures1 if #ej p]c5t ( adults )       
pre-diabetes 7 able to successfully make
 life/yle *anges prov5 to prev5t or     
delay diabetes1 !n by #bjbe             
approximately #d1gjj1jjj new cases (    
diabetes c\ld be prev5t$ at a co/ sav+s 
( #cjj billion4  7#c7 ,prev5t+ diabetes 
& its complications c save money &      
lives4 ,! av]age annual co/ to treat    
someone ) diabetes is #af1geb1 :i* is   
#b4c times high] ?an av]age co/s =      
someone :o does n h diabetes4 ,! ,unit$ 
,/ates sp5ds #cbg billion p] ye> on co/s
 associat$ ) diabetes1 ) gov]nm5t       
insurance includ+ ,m$ic>e cov]+ ov]     
#b_/c ( ^! co/s4  7#d7 ,diabetes is     
unique because its complications & _!   
associat$ heal? c>e co/s are (t5        
prev5table ) curr5tly available m$ical  
treatm5t & life/yle *anges4  7#e7 ,a    

rec5t sy/ematic review conduct$ by !    
,academy ( ,nutrition & ,dietetics      
,evid5ce ,analysis ,libr>y conclud$ t   
r&omiz$ cl9ical trials involv+ m$ical   
nutrition !rapy result$ 9 a significant 
decrease 9 wai/ circumf]5ce1 fa/+ blood 
glucose1 & two-h\r po/ pr&ial blood     
glucose1 :i* is grad$ z /rong evid5ce ( 
hav+ a l[] risk ( develop+ type #b      
diabetes4 ,a second1 indep5d5t sy/ematic
 review ( diabetes prev5tion us+        
nutrition !rapy conduct$ 9 ,europe f\nd 
t individuals :o receiv$ ! life/yle     
int]v5tions _h a #dg-p]c5t r$uc$ risk ( 
develop+ type #b diabetes4  7#f7 ,!     
,m$ic>e program curr5tly provides       
cov]age = scre5+ & id5tify+ b5efici>ies 
) pre-diabetes b does n provide adequate
 s]vices to su* b5efici>ies to help !m  
prev5t or delay ! onset ( diabetes4  #c4
 ,m$ic>e cov]age ( m$ical nutrition     
!rapy s]vices = p ) pre-diabetes & risk 
factors = develop+ type #b diabetes  7a7
 ,9 g5]al ,section #ahfa ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #aciex7 is

 am5d$-- 7#a7 9 subsection 7s77#b77,v71 
by /rik+ a b5efici>y ) diabetes or a    
r5al disease & ins]t+ an individual )   
diabetes1 pre-diabetes 7z def9$ 9       
subsection 7yy77#d771 or a r5al disease1
 or an individual at risk = diabetes 7z 
def9$ 9 subsection 7yy77#b771 9 ! matt] 
prec$+ clause 7i72 &  7#b7 9 subsection 
7yy7-- 7,a7 9 ! head+1 by add+ 2        
,pre-,diabetes at ! end2 &  7,b7 by add+
 at ! end ! foll[+ new p>agraph3  7#d7  
,! t]m pre-diabetes means a condition ( 
impair$ fa/+ glucose or impair$ glucose 
tol]ance id5tifi$ by a blood glucose    
level t is high] ?an normal1 b n s high 
z to indicate actual diabetes4  4  7b7  
,effective date ,! am5dm5ts made by ?is 
section %all apply ) respect to s]vices 
furni%$ on or aft] ,janu>y #a1 #bjba4