I 

111TH CONGRESS 

1ST SESSION H. R. 2590 

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 

MAY 21, 2009 

Ms. DEGETTE (for herself, Mr. CASTLE, Mr. BECERRA, and Mr. KIRK) 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 2009’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) According to the American Diabetes Asso4 ciation, there are 57,000,000 people with pre-diabe5 tes in America. 

6 (2) For a significant number of people with 

7 pre-diabetes, intervening early can reverse elevated 

8 blood glucose levels to normal range and prevent di9 abetes and its complications completely. 

10 (3) Diabetes-related hospitalizations totaled 

11 24.3 million days in 2007, an increase of 7.4 million 

12 from the 16.9 million days in 2002. 

13 (4) Preventing diabetes and its complications 

14 can save money and lives. The average annual cost 

15 to treat someone with diabetes is $11,744. 

16 (5) Diabetes is unique because its complications 

17 and their associated health care cost are preventable 

18 with currently available medical treatment and life19 style changes. 

20 (6) In 2002, the Diabetes Prevention Program 

21 study conducted by the National Institutes of Health 

22 found that participants (all of whom were at in23 creased risk of developing type 2 diabetes) who made 

24 lifestyle changes reduced their risk of developing 

25 type 2 diabetes by 58 percent and that participants 


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1 aged 60 and older reduced their risk of developing 

2 diabetes by 71 percent. 

3 (7) The Agency for Healthcare Research and 

4 Quality (AHRQ) has demonstrated that 

5 $2,500,000,000 in hospitalization costs related to 

6 the treatment of diabetes or complications resulting 

7 from diabetes could be saved by providing seniors 

8 with appropriate primary care to prevent the onset 

9 of diabetes. 

10 (8) The Medicare program currently screens 

11 and identifies beneficiaries with pre-diabetes but 

12 does not provide adequate services to such bene13 ficiaries to prevent them from becoming diabetic. 

14 SEC. 3. MEDICARE COVERAGE OF MEDICAL NUTRITION 

15 THERAPY SERVICES FOR PEOPLE WITH PRE16 DIABETES AND RISK FACTORS FOR DEVEL17 OPING TYPE 2 DIABETES. 

18 (a) IN GENERAL.—Subsection (s)(2)(V) of section 

19 1861 of the Social Security Act (42 U.S.C. 1395x) is 

20 amended— 

21 (1) by inserting ‘‘, pre-diabetes (as defined in 

22 subsection (hhh)),’’ after ‘‘with diabetes’’; and 

23 (2) by inserting ‘‘, or an individual at risk for 

24 diabetes (as defined in subsection (yy)(2)),’’ after 

25 ‘‘or a renal disease’’. 


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1 (b) DEFINITION OF PRE-DIABETES.—Such section is 

2 further amended by adding at the end the following new 

3 subsection: 

4 ‘‘Pre-Diabetes 

5 ‘‘(hhh) The term ‘pre-diabetes’ means a condition of 

6 impaired fasting glucose or impaired glucose tolerance 

7 identified by a blood glucose level that is higher than nor8 mal, but not so high as to indicate actual diabetes.’’. 

9 (c) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply with respect to services furnished 

11 on or after January 1, 2010. 

Æ 


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