SEC. 3. VIRTUAL DIABETES OUTPATIENT SELF-MANAGE-
MENT TRAINING SERVICES DEMONSTRATION 
PROGRAM. 
(a) IN GENERAL.—Beginning not later than January 
1, 2020, the Secretary of Health and Human Services (in 
this section referred to as the ‘‘Secretary’’) shall select an 
appropriate number of applicable beneficiaries to partici-
pate in a 2-year demonstration program to test the impact 
of furnishing diabetes outpatient self-management train-
ing services through a qualified online platform with re-
spect to cost and clinical outcomes for such applicable 
beneficiaries. Under such program, diabetes outpatient 
self-management training services furnished through a 
qualified online platform to an applicable beneficiary shall 
be covered under title XVIII of the Social Security Act, 
and payment for such services shall be made in the same 
manner as payment is made under such title for such serv-
ices furnished in an outpatient setting. 
(b) DEFINITIONS.—In this section: 
(1) APPLICABLE BENEFICIARY.—The term ‘‘ap-
plicable beneficiary’’ means an individual— 
(A) who is enrolled under part B of title 
XVIII of the Social Security Act; 
(B) who has a diagnosis of diabetes; and 
(C) who agrees to take part in the dem-
onstration program described in subsection (a). 
VerDate Sep 11 2014 
22:31 Apr 01, 2019
Jkt 089200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H1840.IH
H1840
kjohnson on DSK79L0C42 with BILLS
(2) QUALIFIED ONLINE PLATFORM.—The term 
‘‘qualified online platform’’ means an online-based 
platform— 
(A) designed to furnish educational and 
training services to an individual with diabetes 
to ensure therapy compliance with respect to 
the individual’s diabetic condition or to provide 
the individual with necessary skills and knowl-
edge (including skills related to the self-admin-
istration of injectable drugs) to participate in 
the individual’s management of such condition; 
and 
(B) that meets the National Standards for 
Diabetes Self-Management Education and Sup-
port, as jointly published by the American Asso-
ciation of Diabetes Educators and the American 
Diabetes Association. 
(3) DIABETES
SELF-MANAGEMENT
TRAINING 
SERVICES.—The term ‘‘diabetes outpatient self-man-
agement training services’’ has the meaning given 
such term in section 1861(qq) of the Social Security 
Act (42 U.S.C. 1395x(qq)) except that the require-
ment in paragraph (1) of such section with respect 
to such services being furnished in an outpatient set-
ting shall not apply. 
VerDate Sep 11 2014 
22:31 Apr 01, 2019
Jkt 089200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H1840.IH
H1840
kjohnson on DSK79L0C42 with BILLS
(c) EVALUATION.—The Secretary shall evaluate the 
demonstration program described in subsection (a) based 
on the following criteria: 
(1) The improvement, if any, in health out-
comes with respect to the diabetic conditions of ap-
plicable beneficiaries participating in such program 
as evidenced by— 
(A) any improvement attributable to such 
program in the knowledge of such beneficiaries 
with respect to such conditions; 
(B) any behavioral changes attributable to 
such program; 
(C) any clinical outcome improvements at-
tributable to such program; 
(D) any quality of life improvements at-
tributable to such program; and 
(E) the overall satisfaction of such bene-
ficiaries with such program. 
(2) Reductions, if any, in expenditures under 
title XVIII of the Social Security Act attributable to 
such program. 
(3) Other criteria determined appropriate by 
the Secretary. 
(d) REPORT.—Not later than 18 months after the 
date of the completion of the demonstration program de-
VerDate Sep 11 2014 
22:31 Apr 01, 2019
Jkt 089200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H1840.IH
H1840
kjohnson on DSK79L0C42 with BILLS
scribed in subsection (a), the Secretary shall submit to 
Congress a report containing— 
(1) the results of the evaluation described in 
subsection (c); 
(2) an analysis of the demographic characteris-
tics of applicable beneficiaries who participated in 
such program; and 
(3) a recommendation on whether such program 
should be continued or expanded. 
(e) WAIVER AUTHORITY.—The Secretary may waive 
such requirements of titles XI and XVIII of the Social 
Security Act (42 U.S.C. 1301 et seq., 1395 et seq.) as 
may be necessary to carry out the provisions of this sec-
tion. 
(f) AUTHORITY TO EXPAND DEMONSTRATION PRO-
GRAM.—Notwithstanding subsection (a), taking into ac-
count the evaluation described in subsection (c), the Sec-
retary may, through rulemaking, expand the duration and 
the scope of the demonstration program described in sub-
section (a), to the extent determined appropriate by the 
Secretary, if— 
(1) the Secretary determines that such expan-
sion is expected to— 
VerDate Sep 11 2014 
22:31 Apr 01, 2019
Jkt 089200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H1840.IH
H1840
kjohnson on DSK79L0C42 with BILLS
(A) reduce spending under title XVIII of 
the Social Security Act without reducing quality 
of care; or 
(B) improve the quality of care for individ-
uals enrolled under part B of such title without 
increasing spending under such title; 
(2) the Chief Actuary of the Centers for Medi-
care & Medicaid Services certifies that such expan-
sion would reduce (or would not result in any in-
crease in) net program spending under such title; 
and 
(3) the Secretary determines that such expan-
sion would not deny or limit the coverage or provi-
sion of benefits under such title for individuals en-
rolled under part B of such title. 
Æ 
VerDate Sep 11 2014 
22:31 Apr 01, 2019
Jkt 089200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6301
E:\BILLS\H1840.IH
H1840
kjohnson on DSK79L0C42 with BILLS