II 

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. 

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 ‘‘National Diabetes 

5 Clinical Care Commission Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) The Centers for Disease Control and Pre9 vention report that nearly 26,000,000 Americans 


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1 have diabetes in addition to an estimated 

2 79,000,000 American adults that have pre-diabetes, 

3 an increase of 2,000,000 Americans with diabetes 

4 and 22,000,000 American adults with pre-diabetes 

5 since 2008. 

6 (2) Diabetes affects 8.3 percent of Americans of 

7 all ages and 11.3 percent of adults age 20 and older. 

8 Individuals of racial and ethnic minorities continue 

9 to have higher rates of diabetes than individuals not 

10 of such minorities, as demonstrated by the following: 

11 16.1 percent of all adult American Indians and Alas12 kan Natives have diabetes; 12.6 percent of all adult 

13 African-Americans have diabetes; 11.8 percent of all 

14 adult Hispanics have diabetes; and 8.4 percent of all 

15 adult Asian-Americans have diabetes, while 7.1 per16 cent of all non-Hispanic Whites have diabetes. 

17 (3) Diabetes is the seventh leading cause of 

18 death in the United States. 

19 (4) People with diabetes are more likely than 

20 people without diabetes to have heart attacks, 

21 strokes, high blood pressure, kidney failure, blind22 ness, and require amputations. 

23 (5) Total national costs associated with diabetes 

24 in 2007 exceeded $174,000,000,000, according to 

25 the Centers for Disease Control and Prevention. 


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1 (6) One in three Medicare dollars is currently 

2 spent on people with diabetes. 

3 (7) The Centers for Disease Control and Pre4 vention projects that as many as 1 in 3 American 

5 adults could have diabetes by 2050 if current trends 

6 continue. 

7 (8) There are 35 Federal departments, agen8 cies, and offices involved in the implementation of 

9 Federal diabetes activities. 

10 SEC. 3. ESTABLISHMENT OF THE NATIONAL DIABETES 

11 CLINICAL CARE COMMISSION. 

12 Part P of title III of the Public Health Service Act 

13 (42 U.S.C. 280g et seq.) is amended by adding at the end 

14 the following new section: 

15 ‘‘SEC. 399V–6. NATIONAL DIABETES CLINICAL CARE COM16 MISSION. 

17 ‘‘(a) ESTABLISHMENT.—There is hereby established 

18 within the Department of Health and Human Services the 

19 National Diabetes Clinical Care Commission (in this sec20 tion referred to as the ‘Commission’) to evaluate and make 

21 recommendations regarding better coordination and 

22 leveraging of programs within the Department of Health 

23 and Human Services and other Federal agencies that re24 late in any way to supporting appropriate clinical care 

25 (such as any interactions between physicians and other 


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1 health care providers and their patients with pre-diabetes 

2 and diabetes where care is rendered for the management 

3 of their pre-diabetes or diabetes or its complications) for 

4 people with pre-diabetes and diabetes. 

5 ‘‘(b) MEMBERSHIP.— 

6 ‘‘(1) IN GENERAL.—The Commission shall be 

7 composed of the following voting members: 

8 ‘‘(A) The heads (or their designees) of the 

9 following Federal agencies and departments 

10 that conduct programs that could impact the 

11 clinical care of people with pre-diabetes and dia12 betes: 

13 ‘‘(i) The Centers for Medicare and 

14 Medicaid Services. 

15 ‘‘(ii) The Agency for Healthcare Re16 search and Quality. 

17 ‘‘(iii) The Centers for Disease Control 

18 and Prevention. 

19 ‘‘(iv) The Indian Health Service. 

20 ‘‘(v) The Department of Veterans Af21 fairs. 

22 ‘‘(vi) The National Institutes of 

23 Health. 

24 ‘‘(vii) The Food and Drug Adminis25 tration. 


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1 ‘‘(viii) The Health Resources and 

2 Services Administration. 

3 ‘‘(ix) The Department of Defense. 

4 ‘‘(x) Other governmental or non5 governmental agency heads, at the discre6 tion of the agency, that impact clinical 

7 care of individuals with pre-diabetes and 

8 diabetes. 

9 ‘‘(B) Twelve additional voting members ap10 pointed under paragraph (2). 

11 ‘‘(2) ADDITIONAL MEMBERS.—The Commission 

12 shall include additional voting members appointed by 

13 the Comptroller General of the United States, in 

14 consultation with national medical societies and pa15 tient advocate organizations with expertise in diabe16 tes and the care of patients with diabetes, including 

17 one or more from each of the following categories: 

18 ‘‘(A) Clinical endocrinologists. 

19 ‘‘(B) Physician specialties (other than as 

20 described in subparagraph (A)) that play a role 

21 in diabetes care or their complications. 

22 ‘‘(C) Primary care physicians. 

23 ‘‘(D) Non-physician health care profes24 sionals, such as certified diabetes educators, 


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1 clinical dieticians, nurses, nurse practitioners, 

2 and physician assistants. 

3 ‘‘(E) Patient advocates. 

4 ‘‘(F) National experts in the duties listed 

5 under subsection (c). 

6 ‘‘(3) CHAIRPERSON.—The voting members of 

7 the Commission shall select a chairperson from the 

8 members described in paragraph (2)(A). 

9 ‘‘(4) MEETINGS.—The Commission shall meet 

10 at least twice, and not more than 4 times, a year. 

11 ‘‘(5) BOARD TERMS.—Members of the Commis12 sion, including the chairperson, shall serve for a 3- 

13 year term. A vacancy on the Commission shall be 

14 filled in the same manner as the original appoint15 ments. 

16 ‘‘(c) DUTIES.—The Commission shall— 

17 ‘‘(1) evaluate programs of the Department of 

18 Health and Human Services regarding the utiliza19 tion of diabetes screening benefits, annual wellness 

20 visits, and other preventive health benefits that may 

21 reduce the risk of diabetes and its complications, ad22 dressing any existing problems regarding such utili23 zation and related data collection mechanisms; 

24 ‘‘(2) identify current activities and critical gaps 

25 in Federal efforts to support clinicians in providing 


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1 integrated, high-quality care to people with pre-dia2 betes and diabetes; 

3 ‘‘(3) make recommendations regarding the co4 ordination of clinically based activities that are being 

5 supported by the Federal Government; 

6 ‘‘(4) make recommendations regarding the de7 velopment and coordination of federally funded clin8 ical practice support tools for physicians and other 

9 health care professionals in caring for and managing 

10 the care of people with pre-diabetes and diabetes; 

11 ‘‘(5) evaluate programs in existence as of the 

12 date of the enactment of this section and determine 

13 if such programs are meeting the needs identified in 

14 paragraph (2) and, if such programs are determined 

15 to not be meeting such needs, recommend programs 

16 that would be more appropriate; 

17 ‘‘(6) recommend how an outcomes-based reg18 istry may be developed and then used to evaluate 

19 various care models and methods and the impact of 

20 such models and methods on diabetes management 

21 as measured by appropriate care parameters (such 

22 as A1C, blood pressure, and cholesterol levels); 

23 ‘‘(7) evaluate and expand education and aware24 ness to physicians and other health care profesVerDate Mar 14 2013 21:44 Mar 14, 2013 Jkt 029200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S539.IS S539

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1 sionals regarding clinical practices for the prevention 

2 of diabetes and the precursor conditions of diabetes; 

3 ‘‘(8) review and recommend appropriate meth4 ods for outreach and dissemination of educational 

5 resources that regard diabetes prevention and treat6 ments, are funded by the Federal Government, and 

7 are intended for health care professionals and the 

8 public; and 

9 ‘‘(9) include other activities, such as those re10 lating to the areas of public health and nutrition, 

11 that the Commission deems appropriate. 

12 ‘‘(d) OPERATING PLAN.— 

13 ‘‘(1) INITIAL PLAN.—Not later than 90 days 

14 after its first meeting, the Commission shall submit 

15 to the Secretary and the Congress an operating plan 

16 for carrying out the activities of the Commission as 

17 described in subsection (c). Such operating plan may 

18 include— 

19 ‘‘(A) a list of specific activities that the 

20 Commission plans to conduct for purposes of 

21 carrying out the duties described in each of the 

22 paragraphs in subsection (c); 

23 ‘‘(B) a plan for completing the activities; 

24 ‘‘(C) a list of members of the Commission 

25 and other individuals who are not members of 


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1 the Commission who will need to be involved to 

2 conduct such activities; 

3 ‘‘(D) an explanation of Federal agency in4 volvement and coordination needed to conduct 

5 such activities; 

6 ‘‘(E) a budget for conducting such activi7 ties; 

8 ‘‘(F) a plan for evaluating the value and 

9 potential impact of the Commission’s work and 

10 recommendations, including the possible con11 tinuation of the Commission for the purposes of 

12 overseeing their implementation; and 

13 ‘‘(G) other information that the Commis14 sion deems appropriate. 

15 ‘‘(2) UPDATES.—The Commission shall periodi16 cally update the operating plan under paragraph (1) 

17 and submit such updates to the Secretary and the 

18 Congress. 

19 ‘‘(e) FINAL REPORT AND SUNSET OF THE COMMIS20 SION.—By not later than 3 years after the date of the 

21 Commission’s first meeting, the Commission shall submit 

22 to the Secretary and the Congress a report containing all 

23 of the findings and recommendations of the Commission. 

24 Not later than 120 days after the submission of the final 

25 report, the Secretary shall review the evaluation required 


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1 under subsection (d)(1)(F) to determine the continuation 

2 of the Commission. 

3 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—Appro4 priations are authorized to be made available to the Com5 mission for each of fiscal years 2014, 2015, and 2016, 

6 from amounts otherwise made available to the Department 

7 of Health and Human Services for such fiscal years, to 

8 carry out this section.’’. 

Æ 


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