II 

114TH CONGRESS 

1ST SESSION S. 1509 

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 

JUNE 4, 2015 

Mr. CARPER (for himself, Ms. MURKOWSKI, Mr. CASSIDY, Mr. HEINRICH, Mr. 

COONS, and Mr. GRASSLEY) 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 2015’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) According to the Centers for Disease Con9 trol, about 34 percent of adults aged 65 and over 


SSpencer on DSK4SPTVN1PROD with BILLS
2 

•S 1509 IS

1 were obese in the period of 2009 through 2012, rep2 resenting almost 15 million people. 

3 (2) Obesity increases the risk for chronic dis4 eases and conditions, including high blood pressure, 

5 heart disease, certain cancers, arthritis, mental ill6 ness, lipid disorders, sleep apnea, and type 2 diabe7 tes. 

8 (3) More than half of Medicare beneficiaries are 

9 treated for 5 or more chronic conditions per year. 

10 The rate of obesity among Medicare patients dou11 bled from 1987 to 2002, and Medicare spending on 

12 obese individuals during that time more than dou13 bled. 

14 (4) Men and women with obesity at age 65 have 

15 decreased life expectancy of 1.6 years for men and 

16 1.4 years for women. 

17 (5) The direct and indirect cost of obesity is 

18 more than $450 billion annually. 

19 (6) On average, a Medicare beneficiary with 

20 obesity costs $1,964 more than a normal-weight ben21 eficiary. 

22 (7) The prevalence of obesity among older indi23 viduals in the United States is growing at a linear 

24 rate and, if nothing changes, nearly half of the el25 derly population of the United States will have obeVerDate Sep 11 2014 00:33 Jun 06, 2015 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1509.IS S1509

SSpencer on DSK4SPTVN1PROD with BILLS
3 

•S 1509 IS

1 sity in 2030 according to a Congressional Research 

2 Report on obesity. 

3 SEC. 3. AUTHORITY TO EXPAND HEALTH CARE PROVIDERS 

4 QUALIFIED TO FURNISH INTENSIVE BEHAV5 IORAL THERAPY. 

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

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

8 following new paragraph: 

9 ‘‘(4)(A) Subject to subparagraph (B), the Sec10 retary may, in addition to qualified primary care 

11 physicians and other primary care practitioners, 

12 cover intensive behavioral therapy for obesity fur13 nished by any of the following: 

14 ‘‘(i) A physician (as defined in sub15 section (r)(1)) who is not a qualified pri16 mary care physician. 

17 ‘‘(ii) Any other appropriate health 

18 care provider (including a physician assist19 ant, nurse practitioner, or clinical nurse 

20 specialist (as those terms are defined in 

21 subsection (aa)(5)), a clinical psychologist, 

22 a registered dietitian or nutrition profes23 sional (as defined in subsection (vv)). 


SSpencer on DSK4SPTVN1PROD with BILLS
4 

•S 1509 IS

1 ‘‘(iii) An evidence-based, community2 based lifestyle counseling program ap3 proved by the Secretary. 

4 ‘‘(B) In the case of intensive behavioral 

5 therapy for obesity furnished by a provider de6 scribed in clause (ii) or (iii) of subparagraph 

7 (A), the Secretary may only cover such therapy 

8 if such therapy is furnished— 

9 ‘‘(i) upon referral from, and in coordi10 nation with, a physician or primary care 

11 practitioner operating in a primary care 

12 setting or any other setting specified by 

13 the Secretary; and 

14 ‘‘(ii) in an office setting, a hospital 

15 out-patient department, a community16 based site that complies with the Federal 

17 regulations concerning the privacy of indi18 vidually identifiable health information 

19 promulgated under section 264(c) of the 

20 Health Insurance Portability and Account21 ability Act of 1996 (42 U.S.C. 1320d–2 

22 note), or another setting specified by the 

23 Secretary. 

24 ‘‘(C) In order to ensure a collaborative ef25 fort, the coordination described in subparaVerDate Sep 11 2014 00:33 Jun 06, 2015 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1509.IS S1509

SSpencer on DSK4SPTVN1PROD with BILLS
5 

•S 1509 IS

1 graph (B)(i) shall include the health care pro2 vider or lifestyle counseling program commu3 nicating to the referring physician or primary 

4 care practitioner any recommendations or treat5 ment plans made regarding the therapy.’’. 

6 SEC. 4. MEDICARE PART D COVERAGE OF OBESITY MEDI7 CATION. 

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

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

10 amended by inserting after ‘‘restricted under section 

11 1927(d)(2),’’ the following: ‘‘other than subparagraph (A) 

12 of such section if the drug is used for the treatment of 

13 obesity (as defined in section 1861(yy)(2)(C)) or for 

14 weight loss management for an individual who is over15 weight (as defined in section 1861(yy)(2)(F)(i)) and has 

16 one or more related comorbidities,’’. 

17 (b) EFFECTIVE DATE.—The amendment made by 

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

19 after the date that is 2 years after the date of the enact20 ment of this Act. 

21 SEC. 5. REPORT TO CONGRESS. 

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

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

24 the Secretary shall submit a report to Congress describing 

25 the steps the Secretary has taken to implement the Act 


SSpencer on DSK4SPTVN1PROD with BILLS
6 

•S 1509 IS

1 and provide Congress with recommendations for better co2 ordination and leveraging of programs within the Depart3 ment of Health and Human Services and other Federal 

4 agencies that relate in any way to supporting appropriate 

5 research and clinical care (such as any interactions be6 tween physicians and other health care providers and their 

7 patients) to treat, reduce, and prevent obesity in the adult 

8 population. 

Æ 


SSpencer on DSK4SPTVN1PROD with BILLS