```

[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 539 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                 S. 539

    To amend the Public Health Service Act to foster more effective 
 implementation and coordination of clinical care for people with pre-
                         diabetes and diabetes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             March 12, 2013

Mrs. Shaheen (for herself, Ms. Collins, Ms. Klobuchar, and Mrs. Hagan) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL

 
    To amend the Public Health Service Act to foster more effective 
 implementation and coordination of clinical care for people with pre-
                         diabetes and 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 ``National Diabetes Clinical Care 
Commission Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The Centers for Disease Control and Prevention report 
        that nearly 26,000,000 Americans have diabetes in addition to 
        an estimated 79,000,000 American adults that have pre-diabetes, 
        an increase of 2,000,000 Americans with diabetes and 22,000,000 
        American adults with pre-diabetes since 2008.
            (2) Diabetes affects 8.3 percent of Americans of all ages 
        and 11.3 percent of adults age 20 and older. Individuals of 
        racial and ethnic minorities continue to have higher rates of 
        diabetes than individuals not of such minorities, as 
        demonstrated by the following: 16.1 percent of all adult 
        American Indians and Alaskan Natives have diabetes; 12.6 
        percent of all adult African-Americans have diabetes; 11.8 
        percent of all adult Hispanics have diabetes; and 8.4 percent 
        of all adult Asian-Americans have diabetes, while 7.1 percent 
        of all non-Hispanic Whites have diabetes.
            (3) Diabetes is the seventh leading cause of death in the 
        United States.
            (4) People with diabetes are more likely than people 
        without diabetes to have heart attacks, strokes, high blood 
        pressure, kidney failure, blindness, and require amputations.
            (5) Total national costs associated with diabetes in 2007 
        exceeded $174,000,000,000, according to the Centers for Disease 
        Control and Prevention.
            (6) One in three Medicare dollars is currently spent on 
        people with diabetes.
            (7) The Centers for Disease Control and Prevention projects 
        that as many as 1 in 3 American adults could have diabetes by 
        2050 if current trends continue.
            (8) There are 35 Federal departments, agencies, and offices 
        involved in the implementation of Federal diabetes activities.

SEC. 3. ESTABLISHMENT OF THE NATIONAL DIABETES CLINICAL CARE 
              COMMISSION.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following new 
section:

``SEC. 399V-6. NATIONAL DIABETES CLINICAL CARE COMMISSION.

    ``(a) Establishment.--There is hereby established within the 
Department of Health and Human Services the National Diabetes Clinical 
Care Commission (in this section referred to as the `Commission') to 
evaluate and make recommendations regarding 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 clinical care (such as any interactions between 
physicians and other health care providers and their patients with pre-
diabetes and diabetes where care is rendered for the management of 
their pre-diabetes or diabetes or its complications) for people with 
pre-diabetes and diabetes.
    ``(b) Membership.--
            ``(1) In general.--The Commission shall be composed of the 
        following voting members:
                    ``(A) The heads (or their designees) of the 
                following Federal agencies and departments that conduct 
                programs that could impact the clinical care of people 
                with pre-diabetes and diabetes:
                            ``(i) The Centers for Medicare and Medicaid 
                        Services.
                            ``(ii) The Agency for Healthcare Research 
                        and Quality.
                            ``(iii) The Centers for Disease Control and 
                        Prevention.
                            ``(iv) The Indian Health Service.
                            ``(v) The Department of Veterans Affairs.
                            ``(vi) The National Institutes of Health.
                            ``(vii) The Food and Drug Administration.
                            ``(viii) The Health Resources and Services 
                        Administration.
                            ``(ix) The Department of Defense.
                            ``(x) Other governmental or nongovernmental 
                        agency heads, at the discretion of the agency, 
                        that impact clinical care of individuals with 
                        pre-diabetes and diabetes.
                    ``(B) Twelve additional voting members appointed 
                under paragraph (2).
            ``(2) Additional members.--The Commission shall include 
        additional voting members appointed by the Comptroller General 
        of the United States, in consultation with national medical 
        societies and patient advocate organizations with expertise in 
        diabetes and the care of patients with diabetes, including one 
        or more from each of the following categories:
                    ``(A) Clinical endocrinologists.
                    ``(B) Physician specialties (other than as 
                described in subparagraph (A)) that play a role in 
                diabetes care or their complications.
                    ``(C) Primary care physicians.
                    ``(D) Non-physician health care professionals, such 
                as certified diabetes educators, clinical dieticians, 
                nurses, nurse practitioners, and physician assistants.
                    ``(E) Patient advocates.
                    ``(F) National experts in the duties listed under 
                subsection (c).
            ``(3) Chairperson.--The voting members of the Commission 
        shall select a chairperson from the members described in 
        paragraph (2)(A).
            ``(4) Meetings.--The Commission shall meet at least twice, 
        and not more than 4 times, a year.
            ``(5) Board terms.--Members of the Commission, including 
        the chairperson, shall serve for a 3-year term. A vacancy on 
        the Commission shall be filled in the same manner as the 
        original appointments.
    ``(c) Duties.--The Commission shall--
            ``(1) evaluate programs of the Department of Health and 
        Human Services regarding the utilization of diabetes screening 
        benefits, annual wellness visits, and other preventive health 
        benefits that may reduce the risk of diabetes and its 
        complications, addressing any existing problems regarding such 
        utilization and related data collection mechanisms;
            ``(2) identify current activities and critical gaps in 
        Federal efforts to support clinicians in providing integrated, 
        high-quality care to people with pre-diabetes and diabetes;
            ``(3) make recommendations regarding the coordination of 
        clinically based activities that are being supported by the 
        Federal Government;
            ``(4) make recommendations regarding the development and 
        coordination of federally funded clinical practice support 
        tools for physicians and other health care professionals in 
        caring for and managing the care of people with pre-diabetes 
        and diabetes;
            ``(5) evaluate programs in existence as of the date of the 
        enactment of this section and determine if such programs are 
        meeting the needs identified in paragraph (2) and, if such 
        programs are determined to not be meeting such needs, recommend 
        programs that would be more appropriate;
            ``(6) recommend how an outcomes-based registry may be 
        developed and then used to evaluate various care models and 
        methods and the impact of such models and methods on diabetes 
        management as measured by appropriate care parameters (such as 
        A1C, blood pressure, and cholesterol levels);
            ``(7) evaluate and expand education and awareness to 
        physicians and other health care professionals regarding 
        clinical practices for the prevention of diabetes and the 
        precursor conditions of diabetes;
            ``(8) review and recommend appropriate methods for outreach 
        and dissemination of educational resources that regard diabetes 
        prevention and treatments, are funded by the Federal 
        Government, and are intended for health care professionals and 
        the public; and
            ``(9) include other activities, such as those relating to 
        the areas of public health and nutrition, that the Commission 
        deems appropriate.
    ``(d) Operating Plan.--
            ``(1) Initial plan.--Not later than 90 days after its first 
        meeting, the Commission shall submit to the Secretary and the 
        Congress an operating plan for carrying out the activities of 
        the Commission as described in subsection (c). Such operating 
        plan may include--
                    ``(A) a list of specific activities that the 
                Commission plans to conduct for purposes of carrying 
                out the duties described in each of the paragraphs in 
                subsection (c);
                    ``(B) a plan for completing the activities;
                    ``(C) a list of members of the Commission and other 
                individuals who are not members of the Commission who 
                will need to be involved to conduct such activities;
                    ``(D) an explanation of Federal agency involvement 
                and coordination needed to conduct such activities;
                    ``(E) a budget for conducting such activities;
                    ``(F) a plan for evaluating the value and potential 
                impact of the Commission's work and recommendations, 
                including the possible continuation of the Commission 
                for the purposes of overseeing their implementation; 
                and
                    ``(G) other information that the Commission deems 
                appropriate.
            ``(2) Updates.--The Commission shall periodically update 
        the operating plan under paragraph (1) and submit such updates 
        to the Secretary and the Congress.
    ``(e) Final Report and Sunset of the Commission.--By not later than 
3 years after the date of the Commission's first meeting, the 
Commission shall submit to the Secretary and the Congress a report 
containing all of the findings and recommendations of the Commission. 
Not later than 120 days after the submission of the final report, the 
Secretary shall review the evaluation required under subsection 
(d)(1)(F) to determine the continuation of the Commission.
    ``(f) Authorization of Appropriations.--Appropriations are 
authorized to be made available to the Commission for each of fiscal 
years 2014, 2015, and 2016, from amounts otherwise made available to 
the Department of Health and Human Services for such fiscal years, to 
carry out this section.''.
                                 <all>
```