I 

113TH CONGRESS 

1ST SESSION H. R. 1257 

To amend title XVIII of the Social Security Act to reduce the occurrence 

of diabetes in Medicare beneficiaries by extending coverage under Medicare for medical nutrition therapy services to such beneficiaries with 

pre-diabetes or with risk factors for developing type 2 diabetes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 19, 2013 

Ms. DEGETTE (for herself and Mr. WHITFIELD) 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 reduce 

the occurrence of diabetes in Medicare beneficiaries by 

extending coverage under Medicare for medical nutrition 

therapy services to such beneficiaries with pre-diabetes 

or with risk factors for developing type 2 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 ‘‘Preventing Diabetes 

5 in Medicare Act of 2013’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) According to the Centers for Disease Con4 trol and Prevention, there are 79,000,000 adults 

5 with pre-diabetes in America. The Centers estimates 

6 that 50 percent of adults who are 65 years of age 

7 or older have pre-diabetes. More than 90 percent of 

8 adults with pre-diabetes are unaware they have it. 

9 (2) For a significant number of people with 

10 pre-diabetes, early intervention can reverse elevated 

11 blood glucose levels to normal range and prevent di12 abetes and its complications completely or can sig13 nificantly delay its onset. According to the Institute 

14 for Alternative Futures, if 50 percent of adults with 

15 pre-diabetes were able to successfully make lifestyle 

16 changes proven to prevent or delay diabetes, then by 

17 2025 approximately 4,700,000 new cases of diabetes 

18 could be prevented at a cost savings of $300 billion. 

19 (3) Nearly 1-in-5 hospitalizations in 2008 were 

20 related to diabetes according to the Agency for 

21 Healthcare Research and Quality. 

22 (4) Preventing diabetes and its complications 

23 can save money and lives. The average annual cost 

24 to treat someone with diabetes is $11,744, compared 

25 to $2,935 for someone who does not have diabetes. 


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1 One out of every three Medicare dollars is spent on 

2 diabetes. 

3 (5) Diabetes is unique because its complications 

4 and their associated health care costs are often pre5 ventable with currently available medical treatment 

6 and lifestyle changes. 

7 (6) In 2002, the Diabetes Prevention Program 

8 study conducted by the National Institutes of Health 

9 found that participants (all of whom were at in10 creased risk of developing type 2 diabetes) who made 

11 lifestyle changes reduced their risk of developing 

12 type 2 diabetes by 58 percent and that participants 

13 who are 60 years of age or older reduced their risk 

14 of developing diabetes by 71 percent. 

15 (7) The Agency for Healthcare Research and 

16 Quality has demonstrated that $2,500,000,000 in 

17 hospitalization costs related to the treatment of dia18 betes or complications resulting from diabetes could 

19 be saved by providing seniors with appropriate pri20 mary care to prevent the onset of diabetes. 

21 (8) The Medicare program currently provides 

22 coverage for screening and identifying beneficiaries 

23 with pre-diabetes but does not provide adequate 

24 services to such beneficiaries to help them prevent or 

25 delay the onset of diabetes. 


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1 SEC. 3. MEDICARE COVERAGE OF MEDICAL NUTRITION 

2 THERAPY SERVICES FOR PEOPLE WITH PRE3 DIABETES AND RISK FACTORS FOR DEVEL4 OPING TYPE 2 DIABETES. 

5 (a) IN GENERAL.—Section 1861 of the Social Secu6 rity Act (42 U.S.C. 1395x) is amended— 

7 (1) in subsection (s)(2)(V), by striking ‘‘with 

8 diabetes or a renal disease’’ and inserting ‘‘with dia9 betes, pre-diabetes (as defined in subsection (yy)(4)), 

10 or a renal disease, or an individual at risk for diabe11 tes (as defined in subsection (yy)(2)),’’; and 

12 (2) in subsection (yy)— 

13 (A) in the heading, by adding ‘‘; Pre-Dia14 betes’’ at the end; and 

15 (B) by adding at the end the following new 

16 paragraph: 

17 ‘‘(4) The term ‘pre-diabetes’ means a condition of im18 paired fasting glucose or impaired glucose tolerance identi19 fied by a blood glucose level that is higher than normal, 

20 but not so high as to indicate actual diabetes.’’. 

21 (b) EFFECTIVE DATE.—The amendments made by 

22 this section shall apply with respect to services furnished 

23 on or after January 1, 2014. 

Æ 


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