I 
118TH CONGRESS 
2D SESSION 
H. R. 7856 
To amend title XVIII of the Social Security Act to provide for coverage 
of the Medicare Diabetes Prevention program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 2, 2024 
Ms. DEGETTE (for herself, Mr. BILIRAKIS, and Mr. CROW) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for coverage of the Medicare Diabetes Prevention pro-
gram, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Promoting Responsible 
and Effective Virtual Experiences through Novel Tech-
nology to Deliver Improved Access and Better Engage-
ment with Tested and Evidence-based Strategies Act’’ or 
the ‘‘PREVENT DIABETES Act’’. 
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
SEC. 2. MEDICARE DIABETES PREVENTION PROGRAM. 
(a) COVERAGE.— 
(1) IN GENERAL.—Section 1861 of the Social 
Security Act (42 U.S.C. 1395x) is amended— 
(A) in subsection (s)(2), by adding at the 
end the following new subparagraph: 
‘‘(KK) diabetes prevention program services (as 
defined in subsection (nnn));’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(nnn) DIABETES PREVENTION PROGRAM SERV-
ICES.— 
‘‘(1) IN GENERAL.—The term ‘diabetes preven-
tion program services’ means structured behavioral 
health change sessions that— 
‘‘(A) are furnished to an eligible individual 
described in paragraph (2) by a diabetes pre-
vention program supplier for the purpose of 
preventing or delaying the onset of type II dia-
betes; 
‘‘(B) follow a CDC-approved curriculum; 
and 
‘‘(C) are furnished on or after January 1, 
2025. 
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘(2) ELIGIBLE
INDIVIDUAL
DESCRIBED.—An 
eligible individual described in this paragraph is an 
individual that— 
‘‘(A) is entitled to benefits under part A 
and is enrolled under part B; 
‘‘(B) has no previous diagnosis of diabetes 
(other than gestational diabetes); 
‘‘(C) does not have end-stage renal disease; 
and 
‘‘(D) meets additional medical criteria 
specified by the Secretary. 
‘‘(3) NO LIFETIME LIMIT ON PARTICIPATION.— 
There shall be no limitation on the number of times 
an eligible individual may enroll in the diabetes pre-
vention program.’’. 
(2) CONFORMING CHANGE.—Section 1862(a)(1) 
of the Social Security Act (42 U.S.C. 1395y(a)(1)) 
is amended— 
(A) in subparagraph (O), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (P), by striking the 
semicolon at the end and inserting ‘‘, and’’; and 
(C) by adding at the end the following new 
subparagraph: 
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘(Q) in the case of diabetes prevention program 
services (as defined in section 1861(nnn)(1)), which 
are furnished to an individual who is not an eligible 
individual (as defined in section 1861(nnn)(2));’’. 
(b) DIABETES PREVENTION PROGRAM SUPPLIERS.— 
Section 1866 of the Social Security Act (42 U.S.C. 
1395cc) is amended by adding at the end the following 
new subsection: 
‘‘(l) 
DIABETES
PREVENTION
PROGRAM
SUP-
PLIERS.— 
‘‘(1) DIABETES
PREVENTION
PROGRAM
SUP-
PLIER.—In this subsection, the term ‘diabetes pre-
vention program supplier’ means an entity that— 
‘‘(A) is recognized under the Centers for 
Disease Control and Prevention Diabetes Pre-
vention Recognition Program and offers a pro-
gram through an allowable Diabetes Prevention 
Recognition Program delivery mode including 
in-person, online, distance learning, combina-
tion, and other synchronous and asynchronous 
modalities as determined by the Secretary; 
‘‘(B) is enrolled under the diabetes preven-
tion program in accordance with paragraph (2); 
and 
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘(C) meets the requirements described in 
paragraph (2)(B). 
‘‘(2) ENROLLMENT IN DIABETES PREVENTION 
PROGRAM.— 
‘‘(A) APPLICATION.—An entity seeking to 
enroll as a diabetes prevention program supplier 
under this section shall submit to the Secretary 
an application for enrollment at such time and 
in such manner as specified by the Secretary. 
Such application must meet all elements as 
specified by the Secretary. 
‘‘(B) REQUIREMENTS.— 
‘‘(i) 
ADMINISTRATIVE
REQUIRE-
MENTS.—Each diabetes prevention pro-
gram supplier shall maintain— 
‘‘(I) administrative requirements 
as outlined by the Secretary; 
‘‘(II) active enrollment as a dia-
betes prevention program supplier 
under subsection (j); and 
‘‘(III) at least one administrative 
location. 
‘‘(ii) DOCUMENTATION; DATA SUBMIS-
SION.— 
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘(I) DOCUMENTATION.—Each di-
abetes prevention program supplier 
shall maintain documentation in ac-
cordance with standards specified by 
the Secretary. 
‘‘(II) DATA
SUBMISSION.—Each 
diabetes prevention program supplier 
shall maintain information as speci-
fied by the Secretary and submit it to 
the Secretary in the form and manner 
specified by the Secretary. 
‘‘(iii) INSPECTION
AND
REVIEW
RE-
QUIREMENTS.—Each diabetes prevention 
program supplier shall allow the Secretary, 
or any person or organization designated 
by the Secretary, to conduct inspections of 
any administrative location of a diabetes 
prevention program supplier, or of any eli-
gible setting in which diabetes prevention 
program services are furnished, as well as 
review all documentation and records 
maintained by such supplier for purposes 
of the diabetes prevention program. 
‘‘(C) DIABETES
PREVENTION
PROGRAM 
SUPPLIER TERMINATION.—The Secretary may 
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
terminate the enrollment of a diabetes preven-
tion program supplier for purposes of participa-
tion in the diabetes prevention program if such 
supplier— 
‘‘(i) fails to meet the requirements de-
scribed in subparagraph (B); 
‘‘(ii) improperly denies services to an 
eligible individual (as defined in section 
1861(nnn)(2)), including a denial on the 
basis of an eligible individual’s weight, 
health status, or achievement of perform-
ance goals; or 
‘‘(iii) fails to comply with additional 
standards established by the Secretary. 
‘‘(3) ADMINISTRATIVE LOCATION DEFINED.—In 
this subsection, the term ‘administrative location’ 
means a physical location in which a diabetes pre-
vention program supplier is the primary operator of 
such location or the location from which the diabetes 
prevention program supplier’s business is run in the 
case of an online or combination program, and 
where in-person diabetes prevention program serv-
ices may or may not be furnished.’’. 
(c) PAYMENT FOR DIABETES PREVENTION PROGRAM 
SERVICES.—Section 1834 of the Social Security Act (42 
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
U.S.C. 1395m) is amended by adding at the end the fol-
lowing subsection: 
‘‘(aa) PAYMENT FOR DIABETES PREVENTION PRO-
GRAM SERVICES.— 
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish an appropriate payment structure under which 
the Secretary shall make payments to a diabetes 
prevention program supplier for diabetes prevention 
program services furnished to an eligible individual 
(as defined in section 1861(nnn)(2)). 
‘‘(2) ANNUAL
UPDATE.—The Secretary shall 
update the payment structure under this subsection 
annually by the percentage increase in the Consumer 
Price Index for all urban consumers (all items; 
United States city average) for the 12-month period 
ending with June of the preceding year. 
‘‘(3) TERMINATION OF PARTICIPATION.— 
‘‘(A) IN GENERAL.—A diabetes prevention 
program supplier may terminate the participa-
tion of an individual participating in the diabe-
tes prevention program if the individual is no 
longer an eligible individual (as defined in sec-
tion 1862(nnn)(2)). 
‘‘(B) DOCUMENTATION SUPPORTING TER-
MINATION.—In the case of a diabetes preven-
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
tion program supplier that terminates the par-
ticipation of an individual participating in the 
diabetes prevention program, such supplier shall 
maintain records supporting such termination, 
including the date of the termination, the rea-
son for the termination, the details of any inci-
dents leading to such termination, any remedi-
ation efforts taken by such supplier, and any 
final actions taken by such supplier. 
‘‘(4) CONTINUATION OF MEDICARE DIABETES 
PREVENTION PROGRAM EXPANDED MODEL STAND-
ARDS.—Except as specified otherwise in this Act, 
the Secretary shall extend the standards of the 
Medicare Diabetes Prevention Program Expanded 
Model (in effect as of the date of enactment of the 
PREVENT DIABETES Act) to govern the diabetes 
prevention program. 
‘‘(5) DIABETES
PREVENTION
PROGRAM.—In 
this subsection, the term ‘diabetes prevention pro-
gram’ means the payment structure described in this 
subsection.’’. 
SEC. 3. SUNSET OF MDPP EXPANDED MODEL. 
No payment shall be made for services furnished 
under the Medicare Diabetes Prevention Program Ex-
panded Model conducted under section 1115A of the So-
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
cial Security Act (42 U.S.C. 1315a) after January 1, 
2025. 
SEC. 4. UPDATE TO REGULATIONS. 
Not later than November 30, 2024, the Secretary of 
Health and Human Services shall update the regulations 
in sections 410.79, 414.84, 424.200, and 424.205 of title 
42, Code of Federal Regulations, and any other relevant 
regulations, in accordance with sections 2 and 3 of this 
Act. 
SEC. 5. REPORT. 
Not later than January 1, 2028, the Secretary of 
Health and Human Services shall submit to Congress a 
report on the diabetes prevention program. Such report 
shall include a description of the impact of such program 
on— 
(1) participation of eligible individuals and dia-
betes prevention program suppliers in the diabetes 
prevention program as compared to the Medicare 
Diabetes Prevention Program Expanded Model; 
(2) weight loss among eligible individuals; 
(3) health outcomes of eligible individuals; and 
(4) diagnoses and costs relating to type 2 dia-
betes for eligible individuals who have received dia-
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB
betes prevention plan services versus those who have 
not. 
Æ 
VerDate Sep 11 2014 
04:15 Apr 13, 2024
Jkt 049200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6301
E:\BILLS\H7856.IH
H7856
kjohnson on DSK7ZCZBW3PROD with $$_JOB