,,ii #aai? ,,congress #a/ ,session ,s4 #aibe ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,june #b1 #bjbe ,mrs4 ,%ahe5 7= h]self & ,ms4 ,coll9s7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to improve access to diabetes outpati5t self-managem5t tra9+ s]vices1 to require ! ,c5t] = ,m$ic>e & ,m$icaid ,innovation to te/ ! provision ( virtual diabetes outpati5t self-managem5t tra9+ s]vices1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,exp&+ ,access to ,diabetes ,self-,managem5t ,tra9+ ,act ( #bjbe4 #b4 ,improv+ access to diabetes outpati5t self-managem5t tra9+ s]vices 7a7 ,9 g5]al ,section #ahfa7qq7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7qq77 is am5d$-- 7#a7 9 p>agraph 7#a7-- 7,a7 by /rik+ ! ,secret>y det]m9es appropriate & ins]t+ specifi$ 9 p>agraph 7#c72 & 7,b7 by /rik+ ! physician :o is manag+ ! individual's diabetic condition & ins]t+ a physician or qualifi$ nonphysician practition]2 7#b7 9 p>agraph 7#b77;,b71 by /rik+ p>agraph & ins]t+ subp>agraph2 & 7#c7 by add+ at ! end ! foll[+ new p>agraph3 7#c77;,a7 ,= purposes ( p>agraph 7#a7 & subject to subp>agraph 7,b71 ! times specifi$ 9 ?is p>agraph are ! foll[+3 7i7 ,an initial #aj h\rs ( individual or gr\p educational & tra9+ s]vices to rema9 available until us$4 7ii7 ,an additional #b h\rs ( individual or gr\p educational & tra9+ s]vices ea* ye>1 beg9n+ ) ! ye> 9 :i* ! initial #aj h\rs describ$ 9 subp>agraph 7,a7 are complet$4 7,b7 ,! ,secret>y %all n limit ! quantity or duration ( educational & tra9+ s]vices furni%$ by a c]tifi$ provid] to an individual ) diabetes if su* s]vices are deem$ m$ically necess>y by a physician or qualifi$ non-physician practition]4 4 7b7 ,m$ical nutrition !rapy s]vices ,section #ahfa7s77#b77,v7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7s77#b77,v77 is am5d$-- 7#a7 by /rik+ clause 7i72 7#b7 by r$esignat+ clauses 7ii7 & 7iii7 z clauses 7i7 & 7ii71 respectively2 & 7#c7 9 clause 7ii71 z s r$esignat$1 by /rik+ aft] consid]ation ( & ins]t+ consi/5t )4 7c7 ,co/-,%>+ ,section #ahcc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciel7 is am5d$-- 7#a7 9 subsection 7a77#a7-- 7,a7 by /rik+ & 7,,hh7 & ins]t+ 7,,hh72 & 7,b7 by ins]t+ ! foll[+ be=e ! semicolon at ! end3 & 7,,ii7 ) respect to diabetes outpati5t self-managem5t tra9+ s]vices 7z def9$ 9 section #ahfa7qq771 ! am\nt paid %all be #ajj p]c5t ( ! less] ( ! actual *>ge = ! s]vices or ! am\nt det]m9$ "u ! fee s*$ule t applies to su* s]vices "u ?is "p22 & 7#b7 9 subsection 7b71 9 ! fir/ s5t5ce-- 7,a7 by /rik+ 1 & 7#ac7 & ins]t+ 7#ac72 & 7,b7 by /rik+ #ahfa7n744& ins]t+ #ahfa7n71 & 7#ad7 su* d$uctible %all n apply ) respect to diabetes outpati5t self-managem5t tra9+ s]vices 7z def9$ 9 section #ahfa7qq774 7d7 ,application ,! am5dm5ts made by ?is section %all apply ) respect to items & s]vices furni%$ on or aft] ,janu>y #a1 #bjbg4 #c4 ,,cmi te/+ ( provid+ virtual diabetes outpati5t self-managem5t tra9+ s]vices ,section #aaae;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7 is am5d$-- 7#a7 9 subsection 7b77#b77;,a71 by add+ at ! end ! foll[+ new s5t5ce3 8,! models select$ "u ?is subp>agraph %all include ! te/+ ( ! model describ$ 9 subsection 7h7402 & 7#b7 by add+ at ! end ! foll[+ new subsection3 7h7 ,te/+ ( provid+ virtual diabetes outpati5t self-,managem5t tra9+ s]vices 7#a7 ,e/abli%m5t ,n lat] ?an ,janu>y #a1 #bjbf1 ! ,secret>y %all implem5t a model to te/ ! impact ( provid+ cov]age "u title ,,xviii = virtual diabetes outpati5t self-managem5t tra9+ s]vices furni%$ to applicable b5efici>ies ) respect to improv$ heal? outcomes = su* applicable b5efici>ies & r$uc$ exp5ditures "u su* title ,,xviii4 7#b7 ,model design 7,a7 ,9 g5]al ,! ,secret>y %all design ! model "u ?is subsection 9 su* a mann] to all[ = ! evaluation ( demographic *>act]i/ics ( applicable b5efici>ies p>ticipat+ 9 su* model & ! ext5t to :i* su* model accompli%es ! foll[+ purposes3 7i7 ,improvem5t 9 heal? outcomes ) respect to ! diabetic conditions1 includ+ by r$uc+ ,a#a;c levels4 7ii7 ,r$uc$ hospitalizations due to diabetic-relat$ complications4 7iii7 ,increas$ utilization ( diabetes outpati5t self-managem5t tra9+ s]vices z evid5c$ by1 = example1 ,m$ic>e b5efici>y p>ticipation & utilization ( cov]$ h\rs dur+ ! fir/ ye> & subsequ5t ye>s or use ( diabetes outpati5t self-managem5t tra9+ s]vices 9 rural & und]s]v$ communities4 7iv7 ,improv$ m$ication adh]5ce4 7v7 ,r$uc$ exp5ditures "u ?is title attributable to ! model4 7,b7 ,consultation ,9 design+ ! model "u ?is subsection1 ! ,secret>y %all1 n lat] ?an #c mon?s aft] ! date ( ! enactm5t ( ?is subsection1 consult ) /akehold]s 9 ! field ( diabetes c>e & education1 cl9icians 9 ! prim>y c>e community1 exp]ts 9 digital heal?1 & b5efici>y gr\ps4 7#c7 ,def9itions ,9 ?is subsection3 7,a7 ,applicable b5efici>y ,! t]m applicable b5efici>y means an individual ) diabetes z describ$ 9 section #ahfa7qq74 7,b7 ,qualifi$ web-bas$ program ,! t]m qualifi$ web-bas$ program means a web-bas$ program-- 7i7 design$ to furni% educational & tra9+ s]vices to an individual ) diabetes to ensure !rapy compliance ) respect to ! individual's diabetic condition or to provide ! individual ) necess>y skills & k 7includ+ skills relat$ to ! self-adm9i/ration ( injectable drugs7 to p>ticipate 9 ! individual's managem5t ( su* condition2 & 7ii7 t meets ! quality /&>ds describ$ 9 section #ahfa7qq77#b77;,b74 7,c7 ,virtual diabetes outpati5t self-managem5t tra9+ s]vices ,! t]m virtual diabetes outpati5t self-managem5t tra9+ s]vices means any diabetes outpati5t self-managem5t tra9+ s]vices 7z def9$ 9 section #ahfa7qq77 furni%$ by a qualifi$ web-bas$ program = syn*ron\s or asyn*ron\s diabetes outpati5t self-managem5t tra9+ s]vices4 4