I 

112TH CONGRESS 

1ST SESSION H. R. 2787 

To amend title XVIII of the Social Security Act to improve access to diabetes 

self-management training by authorizing certified diabetes educators to 

provide diabetes self-management training services, including as part 

of telehealth services, under part B of the Medicare program. 

IN THE HOUSE OF REPRESENTATIVES 

AUGUST 1, 2011 

Mr. WHITFIELD (for himself and Ms. DEGETTE) 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 improve 

access to diabetes self-management training by authorizing certified diabetes educators to provide diabetes selfmanagement training services, including as part of telehealth services, under part B of the Medicare program. 

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 ‘‘Medicare Diabetes 

5 Self-Management Training Act of 2011’’. 


rfrederick on DSKD9S0YB1PROD with BILLS
2 

•HR 2787 IH

1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) Diabetes self-management training, also 

4 called diabetes education, provides critical knowledge 

5 and skills training to patients with diabetes, helping 

6 them manage medications, address nutritional 

7 issues, facilitate diabetes-related problem solving, 

8 and make other critical lifestyle changes to effec9 tively manage their diabetes. 

10 (2) A certified diabetes educator is a State li11 censed or registered health care professional who 

12 specializes in helping people with diabetes develop 

13 the self-management skills needed to stay healthy 

14 and avoid costly acute complications and emergency 

15 care, as well as debilitating secondary conditions 

16 caused by diabetes. 

17 (3) Diabetes self-management training has been 

18 proven effective in helping to reduce the risks and 

19 complications of diabetes and is a vital component of 

20 an overall diabetes treatment regimen. Patients 

21 under the care of a certified diabetes educator are 

22 better able to control their diabetes and improve 

23 their health status. 

24 (4) Lifestyle changes, such as those taught by 

25 certified diabetes educators, directly contribute to 

26 better glycemic control and reduced complications 


rfrederick on DSKD9S0YB1PROD with BILLS
3 

•HR 2787 IH

1 from diabetes. Evidence shows that the potential for 

2 prevention of the most serious medical complications 

3 caused by diabetes to be as high as 90 percent 

4 (blindness), 85 percent (amputations), and 50 per5 cent (heart disease and stroke) with proper medical 

6 treatment and active self-management. 

7 (5) Despite its effectiveness in reducing diabe8 tes-related complications and associated costs, diabe9 tes self-management training has been recognized by 

10 policymakers as an underutilized Medicare benefit. 

11 Enhancing access to diabetes self-management train12 ing programs that are taught by Certified Diabetes 

13 Educators is an important public policy goal that 

14 can help improve health outcomes, ensure quality, 

15 and reduce escalating diabetes-related health costs. 

16 SEC. 3. RECOGNITION OF CERTIFIED DIABETES EDU17 CATORS AS AUTHORIZED PROVIDERS OF 

18 MEDICARE DIABETES OUTPATIENT SELF19 MANAGEMENT TRAINING SERVICES. 

20 (a) IN GENERAL.—Section 1861(qq) of the Social Se21 curity Act (42 U.S.C. 1395x(qq)) is amended— 

22 (1) in paragraph (1), by striking ‘‘by a certified 

23 provider (as described in paragraph (2)(A)) in an 

24 outpatient setting’’ and inserting ‘‘in an outpatient 

25 setting by a certified diabetes educator (as defined 


rfrederick on DSKD9S0YB1PROD with BILLS
4 

•HR 2787 IH

1 in paragraph (3)) or by a certified provider (as de2 scribed in paragraph (2)(A))’’; and 

3 (2) by adding at the end the following new 

4 paragraphs: 

5 ‘‘(3) For purposes of paragraph (1), the term ‘cer6 tified diabetes educator’ means an individual who— 

7 ‘‘(A) is licensed or registered by the State in 

8 which the services are performed as a health care 

9 professional; 

10 ‘‘(B) specializes in teaching individuals with di11 abetes to develop the necessary skills and knowledge 

12 to manage the individual’s diabetic condition; and 

13 ‘‘(C) is certified as a diabetes educator by a 

14 recognized certifying body (as defined in paragraph 

15 (4)). 

16 ‘‘(4) For purposes of paragraph (3)(C), the term ‘rec17 ognized certifying body’ means a certifying body for diabe18 tes educators which is recognized by the Secretary as au19 thorized to grant certification of diabetes educators for 

20 purposes of this subsection pursuant to standards estab21 lished by the Secretary.’’. 

22 (b) TREATMENT AS A PRACTITIONER, INCLUDING

23 FOR TELEHEALTH SERVICES.—Section 1842(b)(18)(C) of 

24 the such Act (42 U.S.C. 1395u(b)(18)(C)) is amended by 

25 adding at the end the following new clause: 


rfrederick on DSKD9S0YB1PROD with BILLS
5 

•HR 2787 IH

1 ‘‘(vii) A certified diabetes educator (as defined 

2 in section 1861(qq)(3)).’’. 

3 (c) GAO STUDY AND REPORT.— 

4 (1) STUDY.—The Comptroller General of the 

5 United States shall conduct a study to identify the 

6 barriers that exist for Medicare beneficiaries with di7 abetes in accessing diabetes self-management train8 ing services under the Medicare program, including 

9 economic and geographic barriers and availability of 

10 appropriate referrals and access to adequate and 

11 qualified providers. 

12 (2) REPORT.—Not later than 1 year after the 

13 date of the enactment of this Act, the Comptroller 

14 General of the United States shall submit to Con15 gress a report on the study conducted under para16 graph (1). 

17 (d) AHRQ DEVELOPMENT OF RECOMMENDATIONS

18 FOR OUTREACH METHODS AND REPORT.— 

19 (1) DEVELOPMENT OF RECOMMENDATIONS.— 

20 The Director of the Agency for Healthcare Research 

21 and Quality shall, through use of a workshop and 

22 other appropriate means, develop a series of rec23 ommendations on effective outreach methods to edu24 cate primary care physicians and the public about 

25 the benefits of diabetes self-management training in 


rfrederick on DSKD9S0YB1PROD with BILLS
6 

•HR 2787 IH

1 order to promote better health outcomes for patients 

2 with diabetes. 

3 (2) REPORT.—Not later than 1 year after the 

4 date of the enactment of this Act, the Director of 

5 the Agency for Healthcare Research and Quality 

6 shall submit to Congress a report on the rec7 ommendations developed under paragraph (1). 

8 (e) EFFECTIVE DATE.—The amendments made by 

9 this section shall apply to items and services furnished on 

10 or after January 1, 2013. 

Æ 


rfrederick on DSKD9S0YB1PROD with BILLS