,,ii #aahth ,,congress #b;d ,session ,s4 #djid ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,april #aj1 #bjbd,mr4 ,scott of ,south ,carolina 7for himself1 ,mr4 ,warner1 and ,mr4 ,cramer7 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 provide for coverage of the ,medicare ,diabetes ,prevention program1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,promoting ,responsible and ,effective ,virtual ,experiences through ,novel ,technology to ,deliver ,improved ,access and ,better ,engagement with ,tested and ,evidence-based ,strategies ,act or the ,,prevent ,,diabetes ,act4 #b4 ,medicare ,diabetes ,prevention ,program 7a7 ,coverage 7#a7 ,in general ,section #ahfa of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7 is amended-- 7,a7 in subsection 7s77#b71 by adding at the end the following new subparagraph3 7,,kk7 diabetes prevention program services 7as defined in subsection 7nnn772 2 and 7,b7 by adding at the end the following new subsection3 7nnn7 ,diabetes prevention program services 7#a7 ,in general ,the term diabetes prevention program services means structured behavioral health change sessions that-- 7,a7 are furnished to an eligible individual described in paragraph 7#b7 by a diabetes prevention program supplier for the purpose of preventing or delaying the onset of type ,,ii diabetes2 7,b7 follow a ,,cdc-approved curriculum2 and 7,c7 are furnished on or after ,january #a1 #bjbe4 7#b7 ,eligible individual described ,an eligible individual described in this paragraph is an individual that-- 7,a7 is entitled to benefits under part ,a and is enrolled under part ,b2 7,b7 has no previous diagnosis of diabetes 7other than gestational diabetes72 7,c7 does not have end-stage renal disease2 and 7,d7 meets additional medical criteria specified by the ,secretary4 7#c7 ,no lifetime limit on participation ,there shall be no limitation on the number of times an eligible individual may enroll in the diabetes prevention program4 4 7#b7 ,conforming change ,section #ahfb7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciey7a77#a77 is amended-- 7,a7 in subparagraph 7,o71 by striking and at the end2 7,b7 in subparagraph 7,p71 by striking the semicolon at the end and inserting 1 and2 and 7,c7 by adding at the end the following new subparagraph3 7,q7 in the case of diabetes prevention program services 7as defined in section #ahfa7nnn77#a771 which are furnished to an individual who is not an eligible individual 7as defined in section #ahfa7nnn77#b772 4 7b7 ,diabetes prevention program suppliers ,section #ahff of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7 is amended by adding at the end the following new subsection3 7l7 ,diabetes prevention program suppliers 7#a7 ,diabetes prevention program supplier ,in this subsection1 the term diabetes prevention program supplier means an entity that-- 7,a7 is recognized under the ,centers for ,disease ,control and ,prevention ,diabetes ,prevention ,recognition ,program and offers a program through an allowable ,diabetes ,prevention ,recognition ,program delivery mode including in-person1 online1 distance learning1 combination1 and other synchronous and asynchronous modalities as determined by the ,secretary2 7,b7 is enrolled under the diabetes prevention program in accordance with paragraph 7#b72 and 7,c7 meets the requirements described in paragraph 7#b77;,b74 7#b7 ,enrollment in diabetes prevention program 7,a7 ,application ,an entity seeking to enroll as a diabetes prevention program supplier under this section shall submit to the ,secretary an application for enrollment at such time and in such manner as specified by the ,secretary4 ,such application must meet all elements as specified by the ,secretary4 7,b7 ,requirements 7i7 ,administrative requirements ,each diabetes prevention program supplier shall maintain-- 7,i7 administrative requirements as outlined by the ,secretary2 7,,ii7 active enrollment as a diabetes prevention program supplier under subsection 7j72 and 7,,iii7 at least one administrative location4 7ii7 ,documentation2 data submission 7,i7 ,documentation ,each diabetes prevention program supplier shall maintain documentation in accordance with standards specified by the ,secretary4 7,,ii7 ,data submission ,each diabetes prevention program supplier shall maintain information as specified by the ,secretary and submit it to the ,secretary in the form and manner specified by the ,secretary4 7iii7 ,inspection and review requirements ,each diabetes prevention program supplier shall allow the ,secretary1 or any person or organization designated by the ,secretary1 to conduct inspections of any administrative location of a diabetes prevention program supplier1 or of any eligible setting in which diabetes prevention program services are furnished1 as well as review all documentation and records maintained by such supplier for purposes of the diabetes prevention program4 7,c7 ,diabetes prevention program supplier termination ,the ,secretary may terminate the enrollment of a diabetes prevention program supplier for purposes of participation in the diabetes prevention program if such supplier-- 7i7 fails to meet the requirements described in subparagraph 7,b72 7ii7 improperly denies services to an eligible individual 7as defined in section #ahfa7nnn77#b771 including a denial on the basis of an eligible individual's weight1 health status1 or achievement of performance goals2 or 7iii7 fails to comply with additional standards established by the ,secretary4 7#c7 ,administrative location defined ,in this subsection1 the term administrative location means a physical location in which a diabetes prevention program supplier is the primary operator of such location or the location from which the diabetes prevention program supplier's business is run in the case of an online or combination program1 and where in-person diabetes prevention program services may or may not be furnished4 4 7c7 ,payment for diabetes prevention program services 7#a7 ,in general ,section #ahcc7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#a77 is amended-- 7,a7 by striking and 7,,hh7 and inserting 7,,hh72 and 7,b7 in subparagraph 7,,hh71 by striking the semicolon at the end and inserting the following3 1 and 7,,ii7 with respect to diabetes prevention program services furnished on or after ,january #a1 #bjbe1 as described in section #ahfa7nnn71 the amount paid shall be equal to #ajj percent of the payment amount established in the payment structure described in section #ahcd7;aa724 7#b7 ,payment structure ,section #ahcd of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7 is amended by adding at the end the following subsection3 7aa7 ,payment for diabetes prevention program services 7#a7 ,in general ,the ,secretary shall establish an appropriate payment structure under which the ,secretary shall make payments to a diabetes prevention program supplier for diabetes prevention program services furnished to an eligible individual 7as defined in section #ahfa7nnn77#b774 7#b7 ,annual update ,the ,secretary shall update the payment structure under this subsection annually by the percentage increase in the ,consumer ,price ,index for all urban consumers 7all items2 ,united ,states city average7 for the #ab-month period ending with ,june of the preceding year4 7#c7 ,termination of participation 7,a7 ,in general ,a diabetes prevention program supplier may terminate the participation of an individual participating in the diabetes prevention program if the individual is no longer an eligible individual 7as defined in section #ahfb7nnn77#b774 7,b7 ,documentation supporting termination ,in the case of a diabetes prevention program supplier that terminates the participation of an individual participating in the diabetes prevention program1 such supplier shall maintain records supporting such termination1 including the date of the termination1 the reason for the termination1 the details of any incidents leading to such termination1 any remediation efforts taken by such supplier1 and any final actions taken by such supplier4 7#d7 ,continuation of medicare diabetes prevention program expanded model standards ,except as specified otherwise in this ,act1 the ,secretary shall extend the standards of the ,medicare ,diabetes ,prevention ,program ,expanded ,model 7in effect as of the date of enactment of the ,,prevent ,,diabetes ,act7 to govern the diabetes prevention program4 7#e7 ,diabetes prevention program ,in this subsection1 the term diabetes prevention program means the payment structure described in this subsection4 4 #c4 ,sunset of ,,mdpp ,expanded ,model ,no payment shall be made for services furnished under the ,medicare ,diabetes ,prevention ,program ,expanded ,model conducted under section #aaae;,a of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7 after ,january #a1 #bjbe4 #d4 ,update to regulations ,not later than ,november #cj1 #bjbd1 the ,secretary of ,health and ,human ,services shall update the regulations in sections #daj4gi1 #dad4hd1 #dbd4bjj1 and #dbd4bje of title #db1 ,code of ,federal ,regulations1 and any other relevant regulations1 in accordance with sections #b and #c of this ,act4 #e4 ,report ,not later than ,january #a1 #bjbh1 the ,secretary of ,health and ,human ,services shall submit to ,congress a report on the diabetes prevention program4 ,such report shall include a description of the impact of such program on-- 7#a7 participation of eligible individuals and diabetes prevention program suppliers in the diabetes prevention program as compared to the ,medicare ,diabetes ,prevention ,program ,expanded ,model2 7#b7 weight loss among eligible individuals2 7#c7 health outcomes of eligible individuals2 and 7#d7 diagnoses and costs relating to type #b diabetes for eligible individuals who have received diabetes prevention plan services versus those who have not4