A bill to amend title XVIII of the Social Security Act to improve access to diabetes self-management training by authorizing certified diabetes educators to provide diabetes self-management training services, including as part of telehealth services, under part B of the Medicare program.

Summary: Medicare Diabetes Self-Management Training Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act to recognize state-licensed or -registered health care professionals who are certified diabetes educators in an outpatient setting as authorized providers of Medicare diabetes outpatient self-management training services, including as part of telehealth services, under Medicare part B (Supplementary Medical Insurance).

Directs the Comptroller General to study the barriers that exist for Medicare beneficiaries with diabetes in accessing diabetes self-management training services under the Medicare program.

Directs the Director of the Agency for Health Care Research and Quality of the Department of Health and Human Services (HHS) to develop a series of recommendations on effective outreach methods to educate primary care physicians and the public about the benefits of diabetes self-management training.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Diabetes Self-Management 
Training Act of 2011''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Diabetes self-management training, also called diabetes 
        education, provides critical knowledge and skills training to 
        patients with diabetes, helping them manage medications, 
        address nutritional issues, facilitate diabetes related problem 
        solving, and make other critical lifestyle changes to 
        effectively manage their diabetes.
            (2) A certified diabetes educator is a State licensed or 
        registered health care professional who specializes in helping 
        people with diabetes develop the self-management skills needed 
        to stay healthy and avoid costly acute complications and 
        emergency care, as well as debilitating secondary conditions 
        caused by diabetes.
            (3) Diabetes self-management training has been proven 
        effective in helping to reduce the risks and complications of 
        diabetes and is a vital component of an overall diabetes 
        treatment regimen. Patients under the care of a certified 
        diabetes educator are better able to control their diabetes and 
        improve their health status.
            (4) Lifestyle changes, such as those taught by certified 
        diabetes educators, directly contribute to better glycemic 
        control and reduced complications from diabetes. Evidence shows 
        that the potential for prevention of the most serious medical 
        complications caused by diabetes to be as high as 90 percent 
        (blindness), 85 percent (amputations), and 50 percent (heart 
        disease and stroke) with proper medical treatment and active 
        self-management.
            (5) Despite its effectiveness in reducing diabetes related 
        complications and associated costs, diabetes self-management 
        training has been recognized by policymakers as an 
        underutilized Medicare benefit. Enhancing access to diabetes 
        self-management training programs that are taught by Certified 
        Diabetes Educators is an important public policy goal that can 
        help improve health outcomes, ensure quality, and reduce 
        escalating diabetes-related health costs.

SEC. 3. RECOGNITION OF CERTIFIED DIABETES EDUCATORS AS AUTHORIZED 
              PROVIDERS OF MEDICARE DIABETES OUTPATIENT SELF-MANAGEMENT 
              TRAINING SERVICES.

    (a) In General.--Section 1861(qq) of the Social Security Act (42 
U.S.C. 1395x(qq)) is amended--
            (1) in paragraph (1), by striking ``by a certified provider 
        (as described in paragraph (2)(A)) in an outpatient setting'' 
        and inserting ``in an outpatient setting by a certified 
        diabetes educator (as defined in paragraph (3)) or by a 
        certified provider (as described in paragraph (2)(A))''; and
            (2) by adding at the end the following new paragraphs:
    ``(3) For purposes of paragraph (1), the term `certified diabetes 
educator' means an individual who--
            ``(A) is licensed or registered by the State in which the 
        services are performed as a health care professional;
            ``(B) specializes in teaching individuals with diabetes to 
        develop the necessary skills and knowledge to manage the 
        individual's diabetic condition; and
            ``(C) is certified as a diabetes educator by a recognized 
        certifying body (as defined in paragraph (4)).
    ``(4) For purposes of paragraph (3)(C), the term `recognized 
certifying body' means a certifying body for diabetes educators which 
is recognized by the Secretary as authorized to grant certification of 
diabetes educators for purposes of this subsection pursuant to 
standards established by the Secretary.''.
    (b) Treatment as a Practitioner, Including for Telehealth 
Services.--Section 1842(b)(18)(C) of the such Act (42 U.S.C. 
1395u(b)(18)(C)) is amended by adding at the end the following new 
clause:
            ``(vii) A certified diabetes educator (as defined in 
        section 1861(qq)(3)).''.
    (c) GAO Study and Report.--
            (1) Study.--The Comptroller General of the United States 
        shall conduct a study to identify the barriers that exist for 
        Medicare beneficiaries with diabetes in accessing diabetes 
        self-management training services under the Medicare program, 
        including economic and geographic barriers and availability of 
        appropriate referrals and access to adequate and qualified 
        providers.
            (2) Report.--Not later than 1 year after the date of the 
        enactment of this Act, the Comptroller General of the United 
        States shall submit to Congress a report on the study conducted 
        under paragraph (1).
    (d) AHRQ Development of Recommendations for Outreach Methods and 
Report.--
            (1) Development of recommendations.--The Director of the 
        Agency for Healthcare Research and Quality shall, through use 
        of a workshop and other appropriate means, develop a series of 
        recommendations on effective outreach methods to educate 
        primary care physicians and the public about the benefits of 
        diabetes self-management training in order to promote better 
        health outcomes for patients with diabetes.
            (2) Report.--Not later than 1 year after the date of the 
        enactment of this Act, the Director of the Agency for 
        Healthcare Research and Quality shall submit to Congress a 
        report on the recommendations developed under paragraph (1).
    (e) Effective Date.--The amendments made by this section shall 
apply to items and services furnished on or after January 1, 2013.