II 

110TH CONGRESS 

1ST SESSION S. 755 

To amend title XIX of the Social Security Act to require States to provide 

diabetes screening tests under the Medicaid program for adult enrollees 

with diabetes risk factors, to ensure that States offer a comprehensive 

package of benefits under that program for individuals with diabetes, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 2, 2007 

Mr. SCHUMER (for himself and Mr. DOMENICI) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to require 

States to provide diabetes screening tests under the Medicaid program for adult enrollees with diabetes risk factors, to ensure that States offer a comprehensive package 

of benefits under that program for individuals with diabetes, 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 ‘‘Diabetes Screening 

5 and Medicaid Savings Act of 2007’’. 


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1 SEC. 2. IMPROVEMENT OF DIABETES SCREENING AND 

2 TREATMENT UNDER MEDICAID. 

3 (a) DIABETES SCREENING TESTS FOR ADULT EN4 ROLLEES WITH DIABETES RISK FACTORS.—Section 

5 1905(a)(4) of the Social Security Act (42 U.S.C. 

6 1396d(a)(4)) is amended— 

7 (1) in subsection (a)(4)— 

8 (A) by striking ‘‘and’’ before ‘‘(C)’’; and 

9 (B) by inserting after the semicolon at the 

10 end the following ‘‘and (D) diabetes screening 

11 tests (as defined in section 1861(yy)(1)) for an 

12 individual at risk for diabetes (as defined in 

13 subsection (y)) at such intervals as are con14 sistent with the requirements of subparagraph 

15 (B), or in the case of an individual 21 years of 

16 age or older, standards established by the Sec17 retary under section 1861(yy)(3);’’; and 

18 (2) by adding at the end the following new sub19 section: 

20 ‘‘(y) For purposes of subsection (a)(4)(D), the term 

21 ‘individual at risk for diabetes’ means— 

22 ‘‘(1) an individual 45 years of age or older who 

23 is overweight, defined as a body mass index greater 

than 25 kg/m2 24 ; and 


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1 ‘‘(2) an individual under 45 years of age who 

2 is overweight (as so defined) and who has any of the 

3 following risk factors for diabetes: 

4 ‘‘(A) A first-degree relative with diabetes. 

5 ‘‘(B) Hypertension. 

6 ‘‘(C) Dyslipidemia. 

7 ‘‘(D) Habitually inactive. 

8 ‘‘(E) Member of a high risk ethnic popu9 lation for diabetes, including a member of the 

10 following populations: 

11 ‘‘(i) African American. 

12 ‘‘(ii) Latino/Hispanic. 

13 ‘‘(iii) American Indian. 

14 ‘‘(iv) Alaskan Native. 

15 ‘‘(v) Asian American. 

16 ‘‘(vi) Pacific Islander. 

17 ‘‘(F) Previous identification of an impaired 

18 fasting glucose or an impaired glucose toler19 ance. 

20 ‘‘(G) A history of gestational diabetes 

21 mellitus or delivery of a baby weighing greater 

22 than 9 pounds. 

23 ‘‘(H) Polycystic ovarian disease. 

24 ‘‘(I) A history of vascular disease.’’. 


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1 (b) COMPREHENSIVE PACKAGE OF BENEFITS FOR

2 INDIVIDUALS WITH DIABETES.— 

3 (1) IN GENERAL.—Section 1902(a) of the So4 cial Security Act (42 U.S.C. 1396a(a)) is amend5 ed— 

6 (A) in paragraph (69), by striking ‘‘and’’ 

7 at the end; 

8 (B) in paragraph (70)(B)(iv), by striking 

9 the period at the end and inserting ‘‘; and’’; 

10 and 

11 (C) by inserting after paragraph 

12 (70)(B)(iv), the following new paragraph: 

13 ‘‘(71) provide that the medical assistance fur14 nished to any individual who has been determined to 

15 be eligible for such assistance and diagnosed with di16 abetes shall include, in addition to any other items 

17 and services required to be furnished to the indi18 vidual under this title, at least the following items 

19 and services as required by the individual’s treating 

20 physician or healthcare provider: 

21 ‘‘(A) The care and services listed in para22 graphs (1), (2), (3), (4)(B), (4)(D), (5), (10), 

23 and (12) (without regard, in the case of pre24 scribed drugs, to any limit imposed under the 

25 State plan on the number of prescriptions filled 


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1 per month, but subject to any such limit im2 posed by the treating physician or healthcare 

3 provider) of section 1905(a). 

4 ‘‘(B) Durable medical equipment (as de5 fined in section 1861(n)) and other durable 

6 medical equipment covered under title XVIII 

7 through national coverage determinations, in8 cluding insulin pumps and associated supplies. 

9 ‘‘(C) Services related to pregnancy (includ10 ing prenatal, delivery, and post partum serv11 ices). 

12 ‘‘(D) A yearly dilated eye exam by an eye 

13 care professional with appropriate follow-up 

14 care as medically needed. 

15 ‘‘(E) Podiatric services. 

16 ‘‘(F) Diabetes education, including diabe17 tes outpatient self-management training serv18 ices (as defined in section 1861(qq)). 

19 ‘‘(G) Medical nutrition therapy services (as 

20 defined in section 1861(vv)(1)).’’. 

21 (2) PROHIBITION ON COST SHARING.— 

22 (A) IN GENERAL.—Section 1916 of the So23 cial Security Act (42 U.S.C. 1396o) is amended 

24 by adding at the end the following new sub25 section: 


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1 ‘‘(j) In the case of an individual who has been deter2 mined to be eligible for medical assistance and diagnosed 

3 with diabetes— 

4 ‘‘(1) no deduction, cost sharing, or similar 

5 charge shall be imposed for any item or service listed 

6 in subparagraph (A) through (G) of section 

7 1902(a)(71) that is provided to the individual as a 

8 result of the individual’s diagnosis with diabetes or 

9 complications related to such diagnosis; and 

10 ‘‘(2) the State option to impose cost sharing 

11 under section 1916A shall not apply with respect to 

12 the provision of medical assistance to such individual 

13 for any item or service listed in subparagraph (A) 

14 through (G) of section 1902(a)(71) that is provided 

15 to the individual as a result of the individual’s diag16 nosis with diabetes or complications related to such 

17 diagnosis.’’. 

18 (B) CONFORMING AMENDMENT.—The sec19 ond sentence of section 1916A(a)(1) of the So20 cial Security Act (42 U.S.C. 1396o–1(a)(1)) is 

21 amended by striking ‘‘section 1916(g)’’ and in22 serting ‘‘subsection (g) or (j) of section 1916’’. 

23 (c) EFFECTIVE DATE.— 


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1 (1) IN GENERAL.—Except as provided in para2 graph (2), the amendments made by this section 

3 take effect on October 1, 2007. 

4 (2) EXTENSION OF EFFECTIVE DATE FOR

5 STATE LAW AMENDMENT.—In the case of a State 

6 plan under title XIX of the Social Security Act (42 

7 U.S.C. 1396 et seq.) which the Secretary of Health 

8 and Human Services determines requires State legis9 lation in order for the plan to meet the additional 

10 requirements imposed by the amendments made by 

11 this section, the State plan shall not be regarded as 

12 failing to comply with the requirements of such title 

13 solely on the basis of its failure to meet these addi14 tional requirements before the first day of the first 

15 calendar quarter beginning after the close of the 

16 first regular session of the State legislature that be17 gins after the date of enactment of this Act. For 

18 purposes of the previous sentence, in the case of a 

19 State that has a 2-year legislative session, each year 

20 of the session is considered to be a separate regular 

21 session of the State legislature. 

Æ 


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