Treat and Reduce Obesity Act of 2015

Summary: Treat and Reduce Obesity Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to authorize the Department of Health and Human Services (HHS), in addition to qualified primary care physicians and other primary care practitioners, to cover intensive behavioral therapy for obesity furnished by: (1) a physician who is not a qualified primary care physician; (2) an evidence-based, community-based HHS-approved lifestyle counseling program; or (3) any other appropriate health care provider (including a physician assistant, nurse practitioner, clinical nurse specialist, a clinical psychologist, and a registered dietitian or nutrition professional). Allows coverage of intensive behavioral therapy for obesity furnished by another appropriate health care provider or program only if it is furnished: (1) upon referral from, and in coordination with, a physician or primary care practitioner in a primary care or other HHS-specified setting; and (2) in an office setting, a hospital outpatient department, a community-based site that complies with the federal regulations concerning the privacy of individually identifiable health information, or another HHS-specified setting. Authorizes HHS to cover under Medicare part D (Voluntary Prescription Drug Benefit Program) medication for treatment of obesity or for weight loss management for an overweight individual with one or more related comorbidities.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Treat and Reduce Obesity Act of 
2015''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) According to the Centers for Disease Control, about 34 
        percent of adults aged 65 and over were obese in the period of 
        2009 through 2012, representing almost 15 million people.
            (2) Obesity increases the risk for chronic diseases and 
        conditions, including high blood pressure, heart disease, 
        certain cancers, arthritis, mental illness, lipid disorders, 
        sleep apnea, and type 2 diabetes.
            (3) More than half of Medicare beneficiaries are treated 
        for 5 or more chronic conditions per year. The rate of obesity 
        among Medicare patients doubled from 1987 to 2002, and Medicare 
        spending on obese individuals during that time more than 
        doubled.
            (4) Men and women with obesity at age 65 have decreased 
        life expectancy of 1.6 years for men and 1.4 years for women.
            (5) The direct and indirect cost of obesity is more than 
        $450 billion annually.
            (6) On average, a Medicare beneficiary with obesity costs 
        $1,964 more than a normal-weight beneficiary.
            (7) The prevalence of obesity among older individuals in 
        the United States is growing at a linear rate and, if nothing 
        changes, nearly half of the elderly population of the United 
        States will have obesity in 2030 according to a Congressional 
        Research Report on obesity.

SEC. 3. AUTHORITY TO EXPAND HEALTH CARE PROVIDERS QUALIFIED TO FURNISH 
              INTENSIVE BEHAVIORAL THERAPY.

    Section 1861(ddd) of the Social Security Act (42 U.S.C. 1395x(ddd)) 
is amended by adding at the end the following new paragraph:
            ``(4)(A) Subject to subparagraph (B), the Secretary may, in 
        addition to qualified primary care physicians and other primary 
        care practitioners, cover intensive behavioral therapy for 
        obesity furnished by any of the following:
                            ``(i) A physician (as defined in subsection 
                        (r)(1)) who is not a qualified primary care 
                        physician.
                            ``(ii) Any other appropriate health care 
                        provider (including a physician assistant, 
                        nurse practitioner, or clinical nurse 
                        specialist (as those terms are defined in 
                        subsection (aa)(5)), a clinical psychologist, a 
                        registered dietitian or nutrition professional 
                        (as defined in subsection (vv))).
                            ``(iii) An evidence-based, community-based 
                        lifestyle counseling program approved by the 
                        Secretary.
                    ``(B) In the case of intensive behavioral therapy 
                for obesity furnished by a provider described in clause 
                (ii) or (iii) of subparagraph (A), the Secretary may 
                only cover such therapy if such therapy is furnished--
                            ``(i) upon referral from, and in 
                        coordination with, a physician or primary care 
                        practitioner operating in a primary care 
                        setting or any other setting specified by the 
                        Secretary; and
                            ``(ii) in an office setting, a hospital 
                        out-patient department, a community-based site 
                        that complies with the Federal regulations 
                        concerning the privacy of individually 
                        identifiable health information promulgated 
                        under section 264(c) of the Health Insurance 
                        Portability and Accountability Act of 1996 (42 
                        U.S.C. 1320d-2 note), or another setting 
                        specified by the Secretary.
                    ``(C) In order to ensure a collaborative effort, 
                the coordination described in subparagraph (B)(i) shall 
                include the health care provider or lifestyle 
                counseling program communicating to the referring 
                physician or primary care practitioner any 
                recommendations or treatment plans made regarding the 
                therapy.''.

SEC. 4. MEDICARE PART D COVERAGE OF OBESITY MEDICATION.

    (a) In General.--Section 1860D-2(e)(2)(A) of the Social Security 
Act (42 U.S.C. 1395w-102(e)(2)(A)) is amended by inserting after 
``restricted under section 1927(d)(2),'' the following: ``other than 
subparagraph (A) of such section if the drug is used for the treatment 
of obesity (as defined in section 1861(yy)(2)(C)) or for weight loss 
management for an individual who is overweight (as defined in section 
1861(yy)(2)(F)(i)) and has one or more related comorbidities,''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to plan years beginning on or after the date that is 2 years 
after the date of the enactment of this Act.

SEC. 5. REPORT TO CONGRESS.

    Not later than the date that is 1 year after the date of the 
enactment of this Act, and every 2 years thereafter, the Secretary 
shall submit a report to Congress describing the steps the Secretary 
has taken to implement the Act and provide Congress with 
recommendations for better coordination and leveraging of programs 
within the Department of Health and Human Services and other Federal 
agencies that relate in any way to supporting appropriate research and 
clinical care (such as any interactions between physicians and other 
health care providers and their patients) to treat, reduce, and prevent 
obesity in the adult population.