II 

117TH CONGRESS 

1ST SESSION S. 596 

To amend title XVIII of the Social Security Act to provide for the 

coordination of programs to prevent and treat obesity, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 4, 2021 

Mr. CARPER (for himself, Mr. CASSIDY, Mrs. CAPITO, Mr. COONS, Mrs. 

BLACKBURN, Ms. KLOBUCHAR, Mrs. HYDE-SMITH, Mrs. SHAHEEN, Ms. 

SINEMA, Ms. ERNST, Ms. MURKOWSKI, Mr. CRAMER, Mr. TILLIS, and 

Mr. HEINRICH) introduced the following bill; 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 the coordination of programs to prevent and treat 

obesity, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Treat and Reduce Obe5 sity Act of 2021’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 


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1 (1) According to the Centers for Disease Con2 trol and Prevention, about 41 percent of adults aged 

3 60 and over had obesity in the period of 2015 

4 through 2016, representing more than 27 million 

5 people. 

6 (2) The National Institutes of Health has re7 ported that obesity and overweight are now the sec8 ond leading cause of death nationally, with an esti9 mated 300,000 deaths a year attributed to the epi10 demic. 

11 (3) Obesity increases the risk for chronic dis12 eases and conditions, including high blood pressure, 

13 heart disease, certain cancers, arthritis, mental ill14 ness, lipid disorders, sleep apnea, and type 2 diabe15 tes. 

16 (4) More than half of Medicare beneficiaries are 

17 treated for 5 or more chronic conditions per year. 

18 The rate of obesity among Medicare beneficiaries 

19 doubled from 1987 to 2002 and nearly doubled 

20 again by 2016, with Medicare spending on individ21 uals with obesity during that time rising proportion22 ately to reach $50 billion in 2014. 

23 (5) Men and women with obesity at age 65 have 

24 decreased life expectancy of 1.6 years for men and 

25 1.4 years for women. 


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1 (6) The direct and indirect cost of obesity was 

2 more than $427.8 billion in 2014 and is growing. 

3 (7) On average, a Medicare beneficiary with 

4 obesity costs $2,018 (in 2019 dollars) more than a 

5 healthy-weight beneficiary. 

6 (8) The prevalence of obesity among older indi7 viduals in the United States is growing at a linear 

8 rate and, if nothing changes, nearly one in two (47 

9 percent) Medicare beneficiaries aged 65 and over 

10 will have obesity in 2030, up from slightly more 

11 than one in four (28 percent) in 2010. 

12 SEC. 3. AUTHORITY TO EXPAND HEALTH CARE PROVIDERS 

13 QUALIFIED TO FURNISH INTENSIVE BEHAV14 IORAL THERAPY. 

15 Section 1861(ddd) of the Social Security Act (42 

16 U.S.C. 1395x(ddd)) is amended by adding at the end the 

17 following new paragraph: 

18 ‘‘(4)(A) Subject to subparagraph (B), the Sec19 retary may, in addition to qualified primary care 

20 physicians and other primary care practitioners, 

21 cover intensive behavioral therapy for obesity fur22 nished by any of the following: 

23 ‘‘(i) A physician (as defined in subsection 

24 (r)(1)) who is not a qualified primary care phy25 sician. 


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1 ‘‘(ii) Any other appropriate health care 

2 provider (including a physician assistant, nurse 

3 practitioner, or clinical nurse specialist (as 

4 those terms are defined in subsection (aa)(5)), 

5 a clinical psychologist, a registered dietitian or 

6 nutrition professional (as defined in subsection 

7 (vv))). 

8 ‘‘(iii) An evidence-based, community-based 

9 lifestyle counseling program approved by the 

10 Secretary. 

11 ‘‘(B) In the case of intensive behavioral therapy 

12 for obesity furnished by a provider described in 

13 clause (ii) or (iii) of subparagraph (A), the Secretary 

14 may only cover such therapy if such therapy is fur15 nished— 

16 ‘‘(i) upon referral from, and in coordina17 tion with, a physician or primary care practi18 tioner operating in a primary care setting or 

19 any other setting specified by the Secretary; 

20 and 

21 ‘‘(ii) in an office setting, a hospital out22 patient department, a community-based site 

23 that complies with the Federal regulations con24 cerning the privacy of individually identifiable 

25 health information promulgated under section 


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1 264(c) of the Health Insurance Portability and 

2 Accountability Act of 1996, or another setting 

3 specified by the Secretary. 

4 ‘‘(C) In order to ensure a collaborative effort, 

5 the coordination described in subparagraph (B)(i) 

6 shall include the health care provider or lifestyle 

7 counseling program communicating to the referring 

8 physician or primary care practitioner any rec9 ommendations or treatment plans made regarding 

10 the therapy.’’. 

11 SEC. 4. MEDICARE PART D COVERAGE OF OBESITY MEDI12 CATION. 

13 (a) IN GENERAL.—Section 1860D–2(e)(2)(A) of the 

14 Social Security Act (42 U.S.C. 1395w–102(e)(2)(A)) is 

15 amended, in the first sentence— 

16 (1) by striking ‘‘and other than’’ and inserting 

17 ‘‘other than’’; and 

18 (2) by inserting after ‘‘benzodiazepines),’’ the 

19 following: ‘‘and other than subparagraph (A) of such 

20 section if the drug is used for the treatment of obe21 sity (as defined in section 1861(yy)(2)(C)) or for 

22 weight loss management for an individual who is 

23 overweight (as defined in section 1861(yy)(2)(F)(i)) 

24 and has one or more related comorbidities,’’. 


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1 (b) EFFECTIVE DATE.—The amendments made by 

2 subsection (a) shall apply to plan years beginning on or 

3 after the date that is 2 years after the date of the enact4 ment of this Act. 

5 SEC. 5. REPORT TO CONGRESS. 

6 Not later than the date that is 1 year after the date 

7 of the enactment of this Act, and every 2 years thereafter, 

8 the Secretary of Health and Human Services shall submit 

9 a report to Congress describing the steps the Secretary 

10 has taken to implement the provisions of, and amend11 ments made by, this Act. Such report shall also include 

12 recommendations for better coordination and leveraging of 

13 programs within the Department of Health and Human 

14 Services and other Federal agencies that relate in any way 

15 to supporting appropriate research and clinical care (such 

16 as any interactions between physicians and other health 

17 care providers and their patients) to treat, reduce, and 

18 prevent obesity in the adult population. 

Æ 


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