It is not necessary for such individual be diagnosed 
with co-morbidities in addition to the obesity diag-
nosis or body mass index of at least 30 in order to 
be considered an ‘eligible individual’ under this sub-
section.’’. 
(b) PAYMENT.—Section 1833(a)(1) of the Social Se-
curity Act (42 U.S.C. 1395l(a)(1)), as amended by section 
10501(h)(3)(B) of the Patient Protection and Affordable 
Care Act (Public Law 111–148), is amended— 
(1) by striking ‘‘and’’ before ‘‘(Z)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘, and (AA) with respect to items and 
services furnished under an obesity treatment pro-
gram (as defined in section 1861(iii)), the amount 
paid shall be 80 percent of the lesser of the actual 
charge for the services or the amount determined 
under a fee schedule established by the Secretary for 
purposes of this subparagraph’’. 
SEC. 105. COVERAGE OF EVIDENCE-BASED PREVENTIVE 
SERVICES UNDER MEDICAID AND SCHIP. 
(a) STATE OPTION TO PROVIDE MEDICAL ASSIST-
ANCE FOR EVIDENCE-BASED PREVENTIVE SERVICES.— 
(1) IN GENERAL.—Section 1905 of the Social 
Security Act (42 U.S.C. 1396d)— 
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(A) in subsection (a), as amended by sec-
tion 2301(a) of the Patient Protection and Af-
fordable Care Act, is further amended— 
(i) in paragraph (28), by striking 
‘‘and’’ at the end; 
(ii) by redesignating paragraph (29) 
as paragraph (30); and 
(iii) by inserting after paragraph (28) 
the following: 
‘‘(29) evidence-based preventive services de-
scribed in subsection (dd); and’’; and 
(B) as amended by section 10201(c)(6) of 
the Patient Protection and Affordable Care Act, 
is further amended by adding at the end the 
following: 
‘‘(dd) For purposes of subsection (a)(29), evidence- 
based preventive services described in this subsection are 
any preventive services which the Secretary has deter-
mined are reasonable and necessary, including, as so de-
termined, diet and exercise counseling, healthy weight and 
obesity counseling, and any other evidence-based, effective 
clinical intervention for obese individuals, including phar-
macological or surgical services, designed to prevent 
comorbidities of obesity.’’. 
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(2) 
CONFORMING
AMENDMENT.—Section 
1902(a)(10)(C)(iv) of such Act is amended by in-
serting ‘‘, and (29)’’ after ‘‘(24)’’. 
(b) STATE OPTION TO PROVIDE CHILD HEALTH AS-
SISTANCE
FOR EVIDENCE-BASED PREVENTIVE SERV-
ICES.—Section 2110(a) of the Social Security Act (42 
U.S.C. 1397jj(a)) is amended— 
(1) by redesignating paragraph (28) as para-
graph (29); and 
(2) by inserting after paragraph (27) the fol-
lowing: 
‘‘(28) Evidence-based preventive services de-
scribed in section 1905(dd).’’. 
SEC. 106. COVERAGE OF MEDICAL NUTRITION THERAPY 
UNDER MEDICAID AND SCHIP. 
(a) STATE OPTION TO PROVIDE MEDICAL ASSIST-
ANCE FOR MEDICAL THERAPY SERVICES.— 
(1) IN GENERAL.—Section 1905(a) of the So-
cial Security Act (42 U.S.C. 1396d), as amended by 
section 105(b), is amended— 
(A) in paragraph (29), by striking ‘‘and’’ 
at the end; 
(B) by redesignating paragraph (30) as 
paragraph (31); and 
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(C) by inserting after paragraph (29) the 
following: 
‘‘(30) medical nutrition therapy services (as de-
fined in section 1861(vv)(1)) for individuals with 
pre-diabetes or obesity, or who are overweight (as 
defined by the Secretary); and″.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
1902(a)(10)(C)(iv) of such Act, as amended by sec-
tion 105(b)(2), is amended by striking ‘‘and (29)’’ 
and inserting ‘‘(29), and (30)’’. 
(b) STATE OPTION TO PROVIDE CHILD HEALTH AS-
SISTANCE
FOR MEDICAL NUTRITION THERAPY SERV-
ICES.—Section 2110(a) of the Social Security Act (42 
U.S.C. 1397jj(a)), as amended by section 105(c), is 
amended— 
(1) by redesignating paragraph (29) as para-
graph (30); and 
(2) by inserting after paragraph (28) the fol-
lowing: 
‘‘(29) Medical nutrition therapy services (as de-
fined in section 1861(vv)(1)) for individuals with 
pre-diabetes or obesity, or who are overweight (as 
defined by the Secretary).’’. 
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SEC. 107. CLARIFICATION OF EPSDT INCLUSION OF PRE-
VENTION, 
SCREENING, 
AND 
TREATMENT 
SERVICES FOR OBESITY AND OVERWEIGHT; 
SCHIP COVERAGE. 
(a) IN GENERAL.—Section 1905(r)(5) of the Social 
Security Act (42 U.S.C. 1396d(r)(5)) is amended by in-
serting before the period the following: ‘‘, including weight 
and BMI measurement and monitoring, as well as appro-
priate treatment services, including medical nutrition ther-
apy services (as defined in section 1861(vv)(1)), physical 
therapy or exercise training, behavioral health counseling, 
and such other evidence-based services as recommended 
by the Secretary (after taking into consideration the 
American Academy of Pediatrics Expert Committee 
Guidelines Regarding the Prevention, Assessment, and 
Treatment of Child and Adolescent Overweight and Obe-
sity)’’. 
(b) SCHIP.— 
(1) REQUIRED COVERAGE.—Section 2103 (42 
U.S.C. 1397cc) is amended— 
(A) in subsection (a), in the matter pre-
ceding paragraph (1), by striking ‘‘and (7)’’ 
and inserting ‘‘(7), and (9)’’; and 
(B) in subsection (c)— 
(i) by redesignating paragraph (7) as 
paragraph (9); and 
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(ii) by inserting after paragraph (6), 
the following: 
‘‘(7) PREVENTION, SCREENING, AND
TREAT-
MENT SERVICES FOR OBESITY AND OVERWEIGHT.— 
The child health assistance provided to a targeted 
low-income child shall include coverage of weight 
and BMI measurement and monitoring, as well as 
appropriate treatment services (including but not 
limited to) medical nutrition therapy services (as de-
fined in section 1861(vv)(1)), physical therapy or ex-
ercise training, behavioral health counseling, and 
such other evidence-based services as recommended 
by the Secretary. For purposes of the previous sen-
tence the Secretary shall take into consideration the 
American Academy of Pediatrics Expert Committee 
Guidelines Regarding the Prevention, Assessment, 
and Treatment of Child and Adolescent Overweight 
and Obesity.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
2102(a)(7)(B) (42 U.S.C. 1397bb(c)(2)) is amended 
by striking ‘‘section 2103(c)(5)’’ and inserting 
‘‘paragraphs (5) and (7) of section 2103(c)’’. 
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SEC. 108. GRANTS TO INCREASE PHYSICAL ACTIVITY, IM-
PROVE NUTRITION, AND PROMOTE HEALTHY 
EATING BEHAVIORS. 
Part Q of title III of the Public Health Service Act 
(42 U.S.C. 280h et seq.) is amended by striking section 
399W and inserting the following: 
‘‘SEC. 399W. GRANTS TO INCREASE PHYSICAL ACTIVITY, IM-
PROVE NUTRITION, AND PROMOTE HEALTHY 
EATING BEHAVIORS. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention and in coordination with the 
Administrator of the Health Resources and Services 
Administration, the Director of the Indian Health 
Service, the Secretary of Education, the Secretary of 
Agriculture, the Secretary of the Interior, the Direc-
tor of the National Institutes of Health, the Director 
of the Office of Women’s Health, and the heads of 
other appropriate agencies, shall award competitive 
grants to eligible entities to plan and implement pro-
grams that promote healthy eating behaviors and 
physical activity to prevent obesity, being overweight, 
and related serious and chronic medical conditions. 
‘‘(2) SPECIAL PRIORITY.—In awarding grants 
under this section, the Secretary shall give special 
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priority to grant proposals that target communities 
or populations disproportionately at-risk from obe-
sity or being overweight, including health disparity 
populations (as defined in section 485E(d)), the un-
derserved, and youth. 
‘‘(3) TERM.—The Secretary shall award grants 
under this subsection for a period not to exceed 4 
years. 
‘‘(b) AWARD OF GRANTS.—An eligible entity desiring 
a grant under this section shall submit an application to 
the Secretary at such time, in such manner, and con-
taining such information as the Secretary may require, in-
cluding— 
‘‘(1) a plan describing a comprehensive pro-
gram of approaches to encourage healthy eating be-
haviors and healthy levels of physical activity; 
‘‘(2) the manner in which the eligible entity will 
coordinate with appropriate State and local authori-
ties and community-based organizations, including— 
‘‘(A) State and local educational agencies; 
‘‘(B) departments of health; 
‘‘(C) chronic disease directors; 
‘‘(D) State directors of programs under 
section 17 of the Child Nutrition Act of 1966; 
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‘‘(E) governors’ councils for physical activ-
ity and good nutrition; 
‘‘(F) State and local parks and recreation 
departments; 
‘‘(G) State and local departments of trans-
portation and city planning; and 
‘‘(H) community-based organizations serv-
ing youth; and 
‘‘(3) the manner in which the applicant will 
evaluate the effectiveness of the program carried out 
under this section. 
‘‘(c) COORDINATION.—In awarding grants under this 
section, the Secretary shall ensure that the proposed pro-
grams are coordinated in substance and format with pro-
grams currently funded through other Federal agencies 
and operating within the community including the Phys-
ical Education Program (PEP) of the Department of Edu-
cation. 
‘‘(d) ELIGIBLE ENTITY.—In this section, the term 
‘eligible entity’ means— 
‘‘(1) a city, county, tribe, territory, or State; 
‘‘(2) a State educational agency; 
‘‘(3) a tribal educational agency; 
‘‘(4) a local educational agency; 
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‘‘(5) a federally qualified health center (as de-
fined in section 1861(aa)(4) of the Social Security 
Act); 
‘‘(6) a rural health clinic; 
‘‘(7) a health department; 
‘‘(8) an Indian Health Service hospital or clinic; 
‘‘(9) an Indian tribal health facility; 
‘‘(10) an urban Indian facility; 
‘‘(11) any health provider; 
‘‘(12) an accredited university or college; 
‘‘(13) a community-based organization; 
‘‘(14) a local city planning agency; 
‘‘(15) a State or local parks and recreation de-
partment; or 
‘‘(16) any other entity determined appropriate 
by the Secretary. 
‘‘(e) USE OF FUNDS.—An eligible entity that receives 
a grant under this section shall use the funds made avail-
able through the grant to— 
‘‘(1) carry out community-based activities in-
cluding— 
‘‘(A) city planning, transportation initia-
tives, and environmental changes that help pro-
mote physical activity, such as increasing the 
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use of walking or bicycling as a mode of trans-
portation; 
‘‘(B) forming partnerships and activities 
with businesses, disability organizations, com-
munity-based organizations, and other entities 
to increase physical activity levels and promote 
healthy eating behaviors in schools and while 
traveling to and from schools; 
‘‘(C) forming partnerships with entities, in-
cluding schools, faith-based entities, commu-
nity-based organizations, and other organiza-
tions providing recreational services, to estab-
lish programs that use their facilities or other 
resources for after-school, weekend, and sum-
mer community activities, especially those that 
promote or involve physical activity; 
‘‘(D) establishing incentives for retail food 
stores, farmer’s markets, food co-ops, grocery 
stores, and other retail food outlets that offer 
fruits and vegetables and other nutritious foods 
to encourage such stores and outlets to locate 
in economically depressed areas; 
‘‘(E) forming partnerships with senior cen-
ters, nursing facilities, retirement communities, 
and assisted living facilities to establish pro-
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grams for older people to foster physical activ-
ity and healthy eating behaviors; 
‘‘(F) forming partnerships with daycare 
and after-school entities to establish programs 
that promote healthy eating behaviors and 
physical activity; 
‘‘(G) developing and evaluating community 
educational activities targeting good nutrition 
and promoting healthy eating behaviors; and 
‘‘(H) providing, directly or in cooperation 
with State and local parks and recreation de-
partments, programs and other opportunities 
for daily physical activity; 
‘‘(2) carry out age-appropriate school-based ac-
tivities including— 
‘‘(A) developing and testing educational 
curricula and intervention programs designed to 
promote healthy eating behaviors and habits in 
youth, which may include— 
‘‘(i) after hours physical activity pro-
grams; 
‘‘(ii) increasing opportunities for stu-
dents to make informed choices regarding 
healthy eating behaviors; and 
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‘‘(iii) science-based interventions with 
multiple components to prevent obesity and 
being overweight including nutritional con-
tent, understanding and responding to 
hunger and satiety, positive body image de-
velopment, positive self-esteem develop-
ment, and learning life skills (such as 
stress management, communication skills, 
problem-solving and decisionmaking skills), 
as well as consideration of cultural and de-
velopmental issues, and the role of family, 
school, and community; 
‘‘(B) providing education and training to 
educational professionals regarding a healthy 
lifestyle and a healthy school environment; 
‘‘(C) planning and implementing a healthy 
lifestyle curriculum or program with an empha-
sis on healthy eating behaviors and physical ac-
tivity; and 
‘‘(D) planning and implementing healthy 
lifestyle classes or programs for parents or 
guardians, with an emphasis on healthy eating 
behaviors and physical activity; 
‘‘(3) carry out activities through the local 
health care delivery systems including— 
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‘‘(A) promoting healthy eating behaviors 
and physical activity services to treat or prevent 
obesity and being overweight; 
‘‘(B) providing patient education and coun-
seling to increase physical activity and promote 
healthy eating behaviors; and 
‘‘(C) providing community education on 
good nutrition and physical activity to develop 
a better understanding of the relationship be-
tween diet, physical activity, and obesity or 
being overweight; or 
‘‘(4) other activities determined appropriate by 
the Secretary (including evaluation or identification 
and dissemination of outcomes and best practices). 
‘‘(f) MATCHING FUNDS.—In awarding grants under 
subsection (a), the Secretary may give priority to eligible 
entities who provide matching contributions. Such non- 
Federal contributions may be cash or in kind, fairly evalu-
ated, including plant, equipment, or services. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary may 
set aside an amount not to exceed 10 percent of the total 
amount appropriated for a fiscal year pursuant to sub-
section (k) to permit the Director of the Centers for Dis-
ease Control and Prevention to provide grantees with tech-
nical support in the development, implementation, and 
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evaluation of programs under this section and to dissemi-
nate information about effective strategies and interven-
tions in preventing and treating obesity through the pro-
motion of healthy eating behaviors and physical activity. 
‘‘(h) LIMITATION ON ADMINISTRATIVE COSTS.—An 
eligible entity awarded a grant under this section may not 
use more than 10 percent of funds awarded under such 
grant for administrative expenses. 
‘‘(i) REPORT.—Not later than 6 years after the date 
of enactment of the Improved Nutrition and Physical Ac-
tivity Act, the Director of the Centers for Disease Control 
and Prevention shall review the results of the grants 
awarded under this section and other related research and 
identify programs that have demonstrated effectiveness in 
promoting healthy eating behaviors and physical activity 
in youth. Such review shall include an identification of 
model curricula, best practices, and lessons learned, as 
well as recommendations for next steps to reduce obesity 
and being overweight. Information derived from such re-
view, including model program curricula, shall be dissemi-
nated to the public. 
‘‘(j) DEFINITIONS.—In this section: 
‘‘(1) HEALTHY EATING BEHAVIORS.—The term 
‘healthy eating behaviors’ means— 
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‘‘(A) eating in quantities adequate to meet, 
but not in excess of, daily energy needs; 
‘‘(B) choosing foods to promote health and 
prevent disease; 
‘‘(C) eating comfortably in social environ-
ments that promote healthy relationships with 
family, peers, and community; and 
‘‘(D) eating in a manner to acknowledge 
internal signals of hunger and satiety. 
‘‘(2) OBESE.—The term ‘obese’ refers to an 
adult with a Body Mass Index (BMI) of 30 kg/m2 
or greater, or a child or adolescent with a BMI at 
or above the 95th percentile on the revised Centers 
for Disease Control and Prevention growth charts or 
another appropriate childhood definition, as defined 
by the Secretary. 
‘‘(3) OVERWEIGHT.—The term ‘overweight’ re-
fers to an adult with a Body Mass Index (BMI) of 
25 to 29.9 kg/m2 or a child or adolescent with a 
BMI at or above the 85th percentile, but below the 
95th percentile, on the revised Centers for Disease 
Control and Prevention growth charts or another ap-
propriate childhood definition, as defined by the Sec-
retary. 
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‘‘(4) YOUTH.—The term ‘youth’ means individ-
uals not more than 18 years old. 
‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
$60,000,000 for fiscal year 2011, and such sums as may 
be necessary for each of fiscal years 2012 through 2015.’’. 
SEC. 109. GRANTS TO PROVIDE TRAINING FOR HEALTH 
PROFESSION STUDENTS. 
Section 747 of the Public Health Service Act (42 
U.S.C. 293k) is amended— 
(1) by redesignating subsection (c) as sub-
section (d); and 
(2) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) SPECIAL CONSIDERATION.—In awarding grants 
or contracts under subsection (a) or (b), the Secretary 
shall give special consideration to qualified applicants pro-
posing a project or program which will prepare practi-
tioners to care for individuals (including children) who are 
overweight or obese (as such terms are defined in section 
399W(j)).’’. 
SEC. 110. GRANTS TO PROVIDE TRAINING FOR HEALTH 
PROFESSIONALS. 
Section 399Z of the Public Health Service Act (42 
U.S.C. 280h–3) is amended— 
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