Diabetic Vision Loss and Blindness Prevention Act of 2019

To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of digital retinal imaging with remote interpretation. 1. Short title This Act may be cited as the Diabetic Vision Loss and Blindness Prevention Act of 2019 2. Medicare coverage of digital retinal imaging with remote interpretation (a) Coverage Section 1861 of the Social Security Act ( 42 U.S.C. 1395x (1) in subsection (s)(2)— (A) in subparagraph (GG), by striking and (B) in subparagraph (HH), by adding and (C) by inserting after subparagraph (HH) the following new subparagraph: (II) digital retinal imaging with remote interpretation (as defined in subsection (kkk)); ; and (2) by adding at the end the following new subsection: (kkk) Digital Retinal Imaging with Remote Interpretation The term digital retinal imaging with remote interpretation (1) is provided not more frequently than on an annual basis to an individual who has been diagnosed with diabetes and who does not have prior diabetic retinopathy known to the primary care practitioner of the individual; (2) is provided by or under the general supervision of a primary care practitioner (as defined in section 1833(x)) or board-certified endocrinologist; (3) utilizes a retinal camera with optical resolution compliant with the International Organization for Standardization ISO 10940 to take digital images of structures behind the lens of the eye, such as the retina, choroid, and optic nerve; and (4) involves the electronic transmission of such images for evaluation for diabetic retinopathy and other diseases of the eye by a State-licensed ophthalmologist or optometrist. . (b) Payment The payment amount for digital retinal imaging with remote interpretation provided pursuant to the amendments made by section (a) shall be equal to— (1) for the period beginning on October 1, 2019, and ending on December 31, 2019, and for 2020, $51.54; and (2) for a subsequent year, the payment amount specified in subparagraph (1) or this subparagraph for the preceding year increased by the percentage increase in the MEI (as defined in section 1842(i)(3) of the Social Security Act ( 42 U.S.C. 1395u(i)(3) Digital retinal imaging with remote interpretation shall not be considered a telehealth service for purposes of section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)). (c) Patient education and awareness (1) Annual eye exam recommendation The Secretary of Health and Human Services shall ensure that diabetes outpatient self-management training services described in section 1861(qq) of the Social Security Act ( 42 U.S.C. 1395x(qq) (2) Patient awareness The Secretary shall undertake efforts to ensure that patients receiving digital retinal imaging with remote interpretation as described in subsection (kkk) of section 1861 of the Social Security Act ( 42 U.S.C. 1395x

Summary: Diabetic Vision Loss and Blindness Prevention Act of 2019 This bill provides for Medicare coverage of digital retinal imaging with remote interpretation, which is used to detect or assess a certain diabetic eye condition. The Centers for Medicare & Medicaid Services must ensure that beneficiaries who receive such services are also given information about available diabetes self-management training and that such training includes information about the importance of annual eye exams.