II 

112TH CONGRESS 

2D SESSION S. 3699 

To amend title XVIII of the Social Security Act to include information 

on the coverage of intensive behavioral therapy for obesity in the Medicare and You Handbook, to provide written notification to beneficiaries 

and providers regarding new Medicare coverage of intensive behavioral 

therapy for obesity, and to provide for the coordination of programs 

to prevent and treat obesity, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 20, 2012 

Mr. CARPER 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 include 

information on the coverage of intensive behavioral therapy for obesity in the Medicare and You Handbook, 

to provide written notification to beneficiaries and providers regarding new Medicare coverage of intensive behavioral therapy for obesity, and 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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Treat and Reduce Obe3 sity Act of 2012’’. 

4 SEC. 2. FINDINGS. 

5 Congress makes the following findings: 

6 (1) According to the Centers for Disease Con7 trol and Prevention, over 78,000,000 adults in the 

8 United States are obese. 

9 (2) Over 40 percent of women over age 60 and 

10 over 35 percent of men over age 60 are obese. 

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

13 heart disease, and type 2 diabetes. 

14 (4) Forty-nine percent of Americans have at 

15 least one chronic disease. 

16 (5) In 2008, in the United States, health care 

17 costs associated with obesity reached 

18 $147,000,000,000. 

19 (6) Seventy-five percent of Americans will be 

20 overweight or obese by 2020. 

21 (7) Forty-two percent of Americans will be 

22 obese by 2030, resulting in up to $550,000,000,000 

23 in associated health care costs. 


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1 SEC. 3. INCLUSION OF INFORMATION ON COVERAGE OF IN2 TENSIVE BEHAVIORAL THERAPY FOR OBE3 SITY IN THE MEDICARE AND YOU HANDBOOK 

4 AND ADDITIONAL NOTIFICATION OF BENE5 FICIARIES AND PROVIDERS. 

6 (a) INCLUSION OF INFORMATION ON COVERAGE IN

7 THE MEDICARE AND YOU HANDBOOK.— 

8 (1) IN GENERAL.—Section 1804(a) of the So9 cial Security Act (42 U.S.C. 1395b–2(a)) is amend10 ed— 

11 (A) in paragraph (2), by striking ‘‘and’’ at 

12 the end; 

13 (B) in paragraph (3), by striking the pe14 riod at the end and inserting ‘‘, and’’; and 

15 (C) by inserting after paragraph (3) the 

16 following new paragraph: 

17 ‘‘(4) information on the coverage of intensive 

18 behavioral therapy for obesity under this title, in19 cluding information regarding primary care physi20 cians and other providers of services and suppliers 

21 who are eligible to furnish such therapy.’’. 

22 (2) EFFECTIVE DATE.—The amendments made 

23 by this subsection shall apply to notices distributed 

24 on or after the date of enactment of this Act. 

25 (b) NEW NOTIFICATION OF BENEFIT FOR MEDICARE

26 BENEFICIARIES.—Not later than 6 months after the date 


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1 of enactment of this Act, the Secretary of Health and 

2 Human Services shall provide to Medicare beneficiaries 

3 distinct, written notification regarding the coverage of in4 tensive behavioral therapy for obesity under title XVIII 

5 of the Social Security Act (42 U.S.C. 1395 et seq.) as 

6 an additional preventive service. 

7 (c) NOTIFICATION OF BENEFIT FOR MEDICARE PRO8 VIDERS.—Section 1861(ddd) of the Social Security Act 

9 (42 U.S.C. 1395x(ddd)) is amended by adding at the end 

10 the following new paragraph: 

11 ‘‘(4) The Secretary shall provide to primary care phy12 sicians and other providers of services and suppliers deter13 mined appropriate by the Secretary distinct, written notifi14 cation regarding the coverage of intensive behavioral ther15 apy for obesity under this title as an additional preventive 

16 service. Such notification shall be provided annually for 

17 the first 3 years following the date of enactment of the 

18 Treat and Reduce Obesity Act of 2012 and, after such 

19 3-year period, as the Secretary determines appropriate.’’. 


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1 SEC. 4. PLAN FOR COORDINATION OF HHS EFFORTS; PRO2 VIDING THE SECRETARY OF HEALTH AND 

3 HUMAN SERVICES WITH AUTHORITY TO CO4 ORDINATE PROGRAMS TO PREVENT AND 

5 TREAT OBESITY AND EXPAND COVERAGE OP6 TIONS FOR OBESITY UNDER MEDICARE. 

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

8 U.S.C. 1395x(ddd)), as amended by section 3, is amended 

9 by adding at the end the following new paragraph: 

10 ‘‘(5)(A) Not later than 1 year after the date of enact11 ment of the Treat and Reduce Obesity Act of 2012, the 

12 Secretary shall develop and implement a plan to coordi13 nate the efforts of all offices and agencies of the Depart14 ment of Health and Human Services (such as the Centers 

15 for Medicare & Medicaid Services, the Centers for Disease 

16 Control and Prevention, the National Institutes of Health, 

17 the Health Resources and Services Administration, and 

18 other offices and agencies) to treat, reduce, and prevent 

19 obesity and overweight in the adult population. Beginning 

20 2 years after such date of enactment, the Secretary shall 

21 annually update such plan. 

22 ‘‘(B) In developing and implementing the plan under 

23 subparagraph (A), the Secretary shall work with at least 

24 5 representatives, selected by the Secretary, of expert or25 ganizations (such as public health associations, key 

26 healthcare provider groups, planning and development orVerDate Mar 15 2010 00:22 Dec 28, 2012 Jkt 029200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3699.IS S3699

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1 ganizations, education associations, advocacy groups, pa2 tient groups, relevant industries, State and local leader3 ship, and other entities as determined appropriate by the 

4 Secretary). 

5 ‘‘(C) The plan under subparagraph (A) shall include 

6 the following: 

7 ‘‘(i) Strategies to comprehensively treat and re8 duce overweight and obesity. 

9 ‘‘(ii) A description of— 

10 ‘‘(I) the coordination of interagency co11 operation under the plan; and 

12 ‘‘(II) actions under the plan related to the 

13 treatment and reduction of overweight and obe14 sity in the United States. 

15 ‘‘(iii) Identification of best practices in States, 

16 communities, organizations, businesses, and other 

17 entities as appropriate, regarding treatment of over18 weight and obesity. 

19 ‘‘(iv) A description of collaboration with States, 

20 communities, organizations, businesses, and other 

21 appropriate entities to evaluate the effectiveness of 

22 obesity and overweight interventions under the plan. 

23 ‘‘(v) Research initiatives, including ongoing sur24 veillance and monitoring using tools such as the Na25 tional Health and Nutrition Examination Survey 


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1 and the Behavioral Risk Factor Surveillance System 

2 and assurances for adequate and consistent funding 

3 to support data collection and analysis to inform pol4 icy under the plan. 

5 ‘‘(vi) Recommendations for the coordination of 

6 budgets, grant and pilot programs, policies, and pro7 grams across Federal agencies to cohesively treat 

8 overweight and obesity. 

9 ‘‘(D) Not later than 24 months after the date of en10 actment of the Treat and Reduce Obesity Act of 2012, 

11 and on an annual basis thereafter, the Secretary shall sub12 mit to the President and to the relevant committees of 

13 Congress, a report that— 

14 ‘‘(i) summarizes the plan under subparagraph 

15 (A) to coordinate interagency efforts surrounding 

16 the treatment, reduction, and prevention of obesity 

17 and overweight, including a detailed strategic plan 

18 with recommendations for each office and agency in19 volved; 

20 ‘‘(ii) in the case of the second report submitted 

21 under this subparagraph (and each subsequent re22 port), evaluates the effectiveness of those coordi23 nated interventions and conducts interim assess24 ments and reporting of health outcomes, achieveVerDate Mar 15 2010 00:22 Dec 28, 2012 Jkt 029200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3699.IS S3699

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1 ment of milestones, and implementation of strategic 

2 plan goals; and 

3 ‘‘(iii) makes recommendations for updating the 

4 plan for the following year based on data and find5 ings from the previous year. 

6 ‘‘(E) There is authorized to be appropriated to carry 

7 out this paragraph, $5,000,000 for the period of fiscal 

8 years 2014 through 2023, to remain available until ex9 pended.’’. 

10 SEC. 5. AUTHORITY TO EXPAND HEALTH CARE PROVIDERS 

11 QUALIFIED TO FURNISH INTENSIVE BEHAV12 IORAL THERAPY. 

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

14 U.S.C. 1395x(ddd)), as amended by sections 3 and 4, is 

15 amended by adding at the end the following new para16 graph: 

17 ‘‘(6) The Secretary may, in addition to qualified pri18 mary care physicians and other primary care practitioners, 

19 allow other appropriate health care providers (such as 

20 physicians with other primary specialty designations, li21 censed professional counselors, and registered dieticians), 

22 instructors trained in lifestyle counseling programs such 

23 as the Diabetes Prevention Program, and programs recog24 nized by the Centers for Disease Control and Prevention 

25 to provide intensive behavioral therapy for obesity.’’. 


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1 SEC. 6. PROVIDING THE SECRETARY OF HEALTH AND 

2 HUMAN SERVICES WITH THE AUTHORITY TO 

3 INCLUDE CHRONIC WEIGHT MANAGEMENT 

4 DRUGS AS MEDICARE COVERED PART D 

5 DRUGS. 

6 (a) IN GENERAL.—Section 1860D–2(e)(1) of the So7 cial Security Act (42 U.S.C. 1395w–102(e)(1)) is amend8 ed by adding at the end of the flush matter following sub9 paragraph (B) the following new sentence ‘‘Notwith10 standing any other provision of this section, such term 

11 also includes a drug described in the second sentence of 

12 section 1927(d)(2)(A) (relating to drugs used for weight 

13 management) if the Secretary determines that coverage of 

14 such a drug under this part is appropriate.’’. 

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

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

17 after the date that is 2 years after the date of enactment 

18 of this Act. 

Æ 


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