I 

114TH CONGRESS 

1ST SESSION H. R. 2404 

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 HOUSE OF REPRESENTATIVES 

MAY 18, 2015 

Mr. PAULSEN (for himself, Mr. KIND, Mrs. BROOKS of Indiana, Mr. RANGEL, 

Mr. TIPTON, Mr. RUIZ, Mr. HASTINGS, Mr. GUTHRIE, Mr. POCAN, Mr. 

BLUMENAUER, Mr. ROE of Tennessee, Mr. LEWIS, Ms. JENKINS of Kansas, Mr. PETERS, Mr. ISRAEL, Mrs. BLACK, Mr. CA ́RDENAS, Mrs. 

NAPOLITANO, Mr. DANNY K. DAVIS of Illinois, Mr. BENISHEK, Mr. 

RIBBLE, Mr. MURPHY of Pennsylvania, Mr. YOUNG of Indiana, Mr. 

OLSON, Mr. LANCE, Mr. ROSKAM, Mr. RENACCI, Mr. MCGOVERN, Mrs. 

BLACKBURN, Ms. BONAMICI, Mr. CROWLEY, Ms. LINDA T. SA ́NCHEZ of 

California, Mr. SHIMKUS, and Mr. BEN RAY LUJA ́N of New Mexico) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and 

Means, for a period to be subsequently determined by the Speaker, in 

each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Treat and Reduce Obe3 sity Act of 2015’’. 

4 SEC. 2. FINDINGS. 

5 Congress makes the following findings: 

6 (1) According to the Centers for Disease Con7 trol, about 34 percent of adults aged 65 and over 

8 were obese in the period of 2009 through 2012, rep9 resenting almost 15 million people. 

10 (2) Obesity increases the risk for chronic dis11 eases and conditions, including high blood pressure, 

12 heart disease, certain cancers, arthritis, mental ill13 ness, lipid disorders, sleep apnea, and type 2 diabe14 tes. 

15 (3) More than half of Medicare beneficiaries are 

16 treated for 5 or more chronic conditions per year. 

17 The rate of obesity among Medicare patients dou18 bled from 1987 to 2002, and Medicare spending on 

19 obese individuals during that time more than dou20 bled. 

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

22 decreased life expectancy of 1.6 years for men and 

23 1.4 years for women. 

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

25 more than $450 billion annually. 


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1 (6) On average, a Medicare beneficiary with 

2 obesity costs $1,964 more than a normal-weight ben3 eficiary. 

4 (7) The prevalence of obesity among older indi5 viduals in the United States is growing at a linear 

6 rate and, if nothing changes, nearly half of the el7 derly population of the United States will have obe8 sity in 2030 according to a Congressional Research 

9 Report on obesity. 

10 SEC. 3. 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)) is amended by adding at the end the 

15 following new paragraph: 

16 ‘‘(4)(A) Subject to subparagraph (B), the Sec17 retary may, in addition to qualified primary care 

18 physicians and other primary care practitioners, 

19 cover intensive behavioral therapy for obesity fur20 nished by any of the following: 

21 ‘‘(i) A physician (as defined in sub22 section (r)(1)) who is not a qualified pri23 mary care physician. 

24 ‘‘(ii) Any other appropriate health 

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1 ant, nurse practitioner, or clinical nurse 

2 specialist (as those terms are defined in 

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

4 a registered dietitian or nutrition profes5 sional (as defined in subsection (vv))). 

6 ‘‘(iii) An evidence-based, community7 based lifestyle counseling program ap8 proved by the Secretary. 

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

10 therapy for obesity furnished by a provider de11 scribed in clause (ii) or (iii) of subparagraph 

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

13 if such therapy is furnished— 

14 ‘‘(i) upon referral from, and in coordi15 nation with, a physician or primary care 

16 practitioner operating in a primary care 

17 setting or any other setting specified by 

18 the Secretary; and 

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

20 out-patient department, a community21 based site that complies with the Federal 

22 regulations concerning the privacy of indi23 vidually identifiable health information 

24 promulgated under section 264(c) of the 

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1 ability Act of 1996 (42 U.S.C. 1320d–2 

2 note), or another setting specified by the 

3 Secretary. 

4 ‘‘(C) In order to ensure a collaborative ef5 fort, the coordination described in subpara6 graph (B)(i) shall include the health care pro7 vider or lifestyle counseling program commu8 nicating to the referring physician or primary 

9 care practitioner any recommendations or treat10 ment plans made regarding the therapy.’’. 

11 SEC. 4. MEDICARE PART D COVERAGE OF OBESITY MEDI12 CATION. 

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

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

15 amended by inserting after ‘‘restricted under section 

16 1927(d)(2),’’ the following: ‘‘other than subparagraph (A) 

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

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

19 weight loss management for an individual who is over20 weight (as defined in section 1861(yy)(2)(F)(i)) and has 

21 one or more related comorbidities,’’. 

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

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

24 after the date that is 2 years after the date of the enact25 ment of this Act. 


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1 SEC. 5. REPORT TO CONGRESS. 

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

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

4 the Secretary shall submit a report to Congress describing 

5 the steps the Secretary has taken to implement the Act 

6 and provide Congress with recommendations for better co7 ordination and leveraging of programs within the Depart8 ment of Health and Human Services and other Federal 

9 agencies that relate in any way to supporting appropriate 

10 research and clinical care (such as any interactions be11 tween physicians and other health care providers and their 

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

13 population. 

Æ 


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