ing after the item relating to section 725 the fol-
lowing new items: 
‘‘726. Coverage of additional preventive care for individuals with chronic condi-
tions without imposition of cost sharing requirements.’’. 
(b) PHSA.—Part D of title XXVII of the Public 
Health Service Act (42 U.S.C. 300gg–11 et seq.), is 
amended by adding at the end the following new section: 
‘‘SEC. 2799A–11. COVERAGE OF ADDITIONAL PREVENTIVE 
CARE FOR INDIVIDUALS WITH CHRONIC CON-
DITIONS WITHOUT IMPOSITION OF COST 
SHARING REQUIREMENTS. 
‘‘(a) IN GENERAL.—In addition to any item or serv-
ice described in section 2713(a), a group health plan and 
a health insurance issuer offering group or individual 
health insurance coverage shall, at a minimum, provide 
coverage for, and shall not impose any cost sharing re-
quirements for, with respect to individuals with chronic 
conditions (as defined in subsection (b)), such additional 
preventive care and screenings not described in paragraph 
(1) of section 2713(a) that are determined by the Sec-
retary to meet the criteria specified in subsection (c) with 
respect to the chronic condition involved. 
‘‘(b) CHRONIC CONDITION DEFINED.—In this sec-
tion, the term ‘chronic condition’ has the meaning given 
such term by the Secretary and, at a minimum, includes 
the following conditions: 
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‘‘(1) Heart disease, including congestive heart 
failure and coronary artery disease. 
‘‘(2) Diabetes. 
‘‘(3) Osteoporosis and osteopenia. 
‘‘(4) Hypertension. 
‘‘(5) Asthma. 
‘‘(6) Liver disease. 
‘‘(7) Bleeding disorders. 
‘‘(8) Depression. 
‘‘(c) CRITERIA SPECIFIED.—For purposes of sub-
section (a), the criteria specified in this subsection, with 
respect to an item or service and a chronic condition, are 
the following: 
‘‘(1) The item or service is low-cost. 
‘‘(2) There is medical evidence supporting high- 
cost efficiency, or a large expected impact, of the 
item or service in preventing exacerbation of the 
chronic condition or the development of a secondary 
condition. 
‘‘(3) There is a strong likelihood, documented 
by clinical evidence, that the item or service will pre-
vent the exacerbation of the chronic condition or the 
development of a secondary condition that requires 
significantly higher-cost treatments. 
‘‘(d) UPDATES.— 
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‘‘(1) IN GENERAL.—Once every three years, the 
Secretary shall review and update— 
‘‘(A) the list of conditions included within 
the meaning of the term ‘chronic condition’ 
under subsection (b); and 
‘‘(B) the items and services determined to 
meet the criteria specified in subsection (c) for 
purposes of subsection (a). 
‘‘(2) APPLICATION OF UPDATES.—The require-
ment under subsection (a) shall apply with respect 
to an update made under paragraph (1) beginning 
with the first plan year beginning after the date of 
such update.’’. 
(c) IRC.— 
(1) IN
GENERAL.—Subchapter B of chapter 
100 of the Internal Revenue Code of 1986 is amend-
ed by adding at the end the following new section: 
‘‘SEC. 9826. COVERAGE OF ADDITIONAL PREVENTIVE CARE 
FOR INDIVIDUALS WITH CHRONIC CONDI-
TIONS WITHOUT IMPOSITION OF COST SHAR-
ING REQUIREMENTS. 
‘‘(a) IN GENERAL.—In addition to any item or serv-
ice described in section 2713(a) of the Public Health Serv-
ice Act, a group health plan shall, at a minimum, provide 
coverage for, and shall not impose any cost sharing re-
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quirements for, with respect to individuals with chronic 
conditions (as defined in subsection (b)), such additional 
preventive care and screenings not described in paragraph 
(1) of such section 2713(a) that are determined by the 
Secretary to meet the criteria specified in subsection (c) 
with respect to the chronic condition involved. 
‘‘(b) CHRONIC CONDITION DEFINED.—In this sec-
tion, the term ‘chronic condition’ has the meaning given 
such term by the Secretary and, at a minimum, includes 
the following conditions: 
‘‘(1) Heart disease, including congestive heart 
failure and coronary artery disease. 
‘‘(2) Diabetes. 
‘‘(3) Osteoporosis and osteopenia. 
‘‘(4) Hypertension. 
‘‘(5) Asthma. 
‘‘(6) Liver disease. 
‘‘(7) Bleeding disorders. 
‘‘(8) Depression. 
‘‘(c) CRITERIA SPECIFIED.—For purposes of sub-
section (a), the criteria specified in this subsection, with 
respect to an item or service and a chronic condition, are 
the following: 
‘‘(1) The item or service is low-cost. 
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‘‘(2) There is medical evidence supporting high- 
cost efficiency, or a large expected impact, of the 
item or service in preventing exacerbation of the 
chronic condition or the development of a secondary 
condition. 
‘‘(3) There is a strong likelihood, documented 
by clinical evidence, that the item or service will pre-
vent the exacerbation of the chronic condition or the 
development of a secondary condition that requires 
significantly higher-cost treatments. 
‘‘(d) UPDATES.— 
‘‘(1) IN GENERAL.—Once every three years, the 
Secretary shall review and update— 
‘‘(A) the list of conditions included within 
the meaning of the term ‘chronic condition’ 
under subsection (b); and 
‘‘(B) the items and services determined to 
meet the criteria specified in subsection (c) for 
purposes of subsection (a). 
‘‘(2) APPLICATION OF UPDATES.—The require-
ment under subsection (a) shall apply with respect 
to an update made under paragraph (1) beginning 
with the first plan year beginning after the date of 
such update.’’. 
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