I 
113TH CONGRESS 
1ST SESSION 
H. R. 962 
To amend title XVIII of the Social Security Act to reduce the incidence 
of diabetes among Medicare beneficiaries. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 5, 2013 
Mrs. DAVIS of California (for herself and Mr. VELA) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Ways and Means, for a period to be sub-
sequently determined by the Speaker, in each case for consideration of 
such provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to reduce 
the incidence of diabetes among Medicare beneficiaries. 
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 ‘‘Medicare Diabetes 
Prevention Act of 2013’’. 
SEC. 2. DIABETES PREVENTION UNDER THE MEDICARE 
PROGRAM. 
(a) COVERAGE OF DIABETES PREVENTION PROGRAM 
SERVICES.— 
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(1) COVERAGE OF SERVICES.— 
(A) IN GENERAL.—Section 1861(s)(2) of 
the Social Security Act (42 U.S.C. 1395x(s)(2)) 
is amended— 
(i) in subparagraph (EE), by striking 
‘‘and’’ after the semicolon at the end; 
(ii) in subparagraph (FF), by insert-
ing ‘‘and’’ after the semicolon at the end; 
and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(GG) items and services furnished under a di-
abetes prevention program (as defined in subsection 
(iii)(1)) to an eligible diabetes prevention program 
individual (as defined in subsection (iii)(2));’’. 
(B) DEFINITIONS.—Section 1861 of the 
Social Security Act (42 U.S.C. 1395x) is 
amended by adding at the end the following 
new subsection: 
‘‘Diabetes Prevention Program; Eligible Diabetes Preven-
tion Program Individual; Qualified Diabetes Preven-
tion Program Provider 
‘‘(iii)(1)(A) The term ‘diabetes prevention program’ 
means a program that— 
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‘‘(i) meets the criteria described in subpara-
graph (B); and 
‘‘(ii) is furnished by a qualified diabetes preven-
tion program provider (as defined in paragraph 
(3)(A)). 
‘‘(B) The Secretary shall establish the criteria for a 
diabetes prevention program. Such criteria shall be in ac-
cordance with the standards under the National Diabetes 
Prevention Program, as established by the Centers for 
Disease Control and Prevention, and shall require that the 
program complies with the Federal regulations (con-
cerning the privacy of individually identifiable health in-
formation) promulgated under section 264(c) of the 
Health Insurance Portability and Accountability Act of 
1996. In establishing such criteria, the Secretary may also 
consider other factors or clinical evidence as the Secretary 
determines appropriate. 
‘‘(C) Items and services furnished under a diabetes 
prevention program may be furnished in a community set-
ting, as defined by the Secretary. 
‘‘(D) The Secretary shall establish procedures under 
which a qualified diabetes prevention program provider 
may contract with a diabetes prevention program delivery 
partner to furnish the items and services under a diabetes 
prevention program. For purposes of this subsection, the 
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term ‘diabetes prevention program delivery partner’ means 
an entity, including non-profit organizations, public and 
private hospitals, State and local departments of public 
health, and Federally qualified health centers, that meets 
criteria established by the Secretary. Such criteria shall 
be in accordance with the standards under the National 
Diabetes Prevention Program, as established by the Cen-
ters for Disease Control and Prevention. In establishing 
such criteria, the Secretary may also consider other fac-
tors or clinical evidence as the Secretary determines ap-
propriate. 
‘‘(2)(A) The term ‘eligible diabetes prevention pro-
gram individual’ means an individual at risk for diabetes 
(as defined in subsection (yy)(2)) who would benefit from 
items and services under a diabetes prevention program, 
as determined based on criteria established by the Sec-
retary. 
‘‘(B) The criteria established under subparagraph 
(A) shall be in accordance with the standards under the 
National Diabetes Prevention Program, as established by 
the Centers for Disease Control and Prevention. In estab-
lishing such criteria, the Secretary may also consider other 
factors or clinical evidence as the Secretary determines ap-
propriate. 
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