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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3233 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  1st Session
                                S. 3233

     To amend title XVIII of the Social Security Act to reduce the 
occurrence of diabetes in Medicare beneficiaries by extending coverage 
     under Medicare for medical nutrition therapy services to such 
  beneficiaries with pre-diabetes or with risk factors for developing 
                            type 2 diabetes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            November 7, 2023

Mr. Peters (for himself and Mrs. Capito) 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 reduce the 
occurrence of diabetes in Medicare beneficiaries by extending coverage 
     under Medicare for medical nutrition therapy services to such 
  beneficiaries with pre-diabetes or with risk factors for developing 
                            type 2 diabetes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Preventing Diabetes in Medicare Act 
of 2023''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) According to the Centers for Disease Control and 
        Prevention, there are more than 96,000,000 adults with pre-
        diabetes in the United States. The Centers estimates that 27 
        percent of adults who are 65 years of age or older have pre-
        diabetes. More than 80 percent of adults with pre-diabetes do 
        not know they have it.
            (2) For a significant number of people with pre-diabetes, 
        early intervention can reverse elevated blood glucose levels to 
        normal range and prevent diabetes and its complications 
        completely or can significantly delay its onset. According to 
        the Institute for Alternative Futures, if 50 percent of adults 
        with pre-diabetes were able to successfully make lifestyle 
        changes proven to prevent or delay diabetes, then by 2025 
        approximately 4,700,000 new cases of diabetes could be 
        prevented at a cost savings of $300 billion.
            (3) Preventing diabetes and its complications can save 
        money and lives. The average annual cost to treat someone with 
        diabetes is $16,752, which is 2.3 times higher than average 
        costs for someone who does not have diabetes. The United States 
        spends $327 billion per year on costs associated with diabetes, 
        with government insurance including Medicare covering over \2/
        3\ of these costs.
            (4) Diabetes is unique because its complications and their 
        associated health care costs are often preventable with 
        currently available medical treatment and lifestyle changes.
            (5) According to the American Journal of Clinical 
        Nutrition, pre-diabetes medical nutrition therapy provided by a 
        dietitian, such as that found in lifestyle interventions, has 
        the potential to improve glycemic control and prevent 
        progression of type 2 diabetes. In addition, an independent 
        systematic review of diabetes prevention using nutrition 
        therapy conducted in Europe found that individuals who received 
        the lifestyle interventions had a 47-percent reduced risk of 
        developing type 2 diabetes.
            (6) The Medicare program currently provides coverage for 
        screening and identifying beneficiaries with pre-diabetes but 
        does not provide adequate services to such beneficiaries to 
        help them prevent or delay the onset of diabetes.
            (7) According to the Office of Minority Health and Health 
        Equity within the Department of Health and Human Services, 
        diabetes disproportionately affects racial and ethnic minority 
        populations. Compared with White adults, African-American 
        adults are 60 percent more likely to be diagnosed with diabetes 
        by a physician and are twice as likely to die from diabetes.

SEC. 3. MEDICARE COVERAGE OF MEDICAL NUTRITION THERAPY SERVICES FOR 
              PEOPLE WITH PRE-DIABETES AND RISK FACTORS FOR DEVELOPING 
              TYPE 2 DIABETES.

    (a) In General.--Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is amended--
            (1) in subsection (s)(2)(V), by striking ``a beneficiary 
        with diabetes or a renal disease'' and inserting ``an 
        individual with diabetes, pre-diabetes (as defined in 
        subsection (yy)(4)), or a renal disease, or an individual at 
        risk for diabetes (as defined in subsection (yy)(2)),'' in the 
        matter preceding clause (i); and
            (2) in subsection (yy)--
                    (A) in the heading, by adding ``; Pre-Diabetes'' at 
                the end; and
                    (B) by adding at the end the following new 
                paragraph:
    ``(4) The term `pre-diabetes' means a condition of impaired fasting 
glucose or impaired glucose tolerance identified by a blood glucose 
level that is higher than normal, but not so high as to indicate actual 
diabetes.''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished on or after January 1, 2025.
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