I 
108TH CONGRESS 
1ST SESSION H. R. 1860
To promote primary and secondary health promotion and disease prevention 
services and activities among the elderly, to amend title XVIII of the 
Social Security Act to add preventive health benefits, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 29, 2003
Mr. LEVIN (for himself and Mr. FOLEY) 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 subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To promote primary and secondary health promotion and 
disease prevention services and activities among the el-
derly, to amend title XVIII of the Social Security Act 
to add preventive health benefits, 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; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Medicare Wellness Act of 2003’’.
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows:
Sec. 1. Short title; table of contents. 
Sec. 2. Definitions. 
TITLE I—HEALTHY SENIORS PROMOTION PROGRAM 
Sec. 101. Definitions. 
Sec. 102. Working Group on Disease Self-Management and Health Promotion. 
Sec. 103. Healthy seniors promotion grants. 
Sec. 104. Disease self-management demonstration projects. 
TITLE II—MEDICARE COVERAGE OF PREVENTIVE HEALTH 
BENEFITS 
Sec. 201. Therapy and counseling for cessation of tobacco use. 
Sec. 202. Counseling for post-menopausal women. 
Sec. 203. Screening for diminished visual acuity. 
Sec. 204. Screening for type II diabetes mellitus for certain at-risk individuals. 
Sec. 205. Screening for cholesterol. 
Sec. 206. Screening for depression. 
Sec. 207. Expansion of eligibility for bone mass measurement. 
Sec. 208. Coverage of medical nutrition therapy services for beneficiaries with 
cardiovascular diseases. 
Sec. 209. Payment for office visit in connection with screening colonoscopy. 
Sec. 210. Program integrity. 
Sec. 211. Effective date. 
TITLE III—INCREASING UTILIZATION OF MEDICARE PREVENTIVE 
SERVICES 
Sec. 301. Elimination of deductibles and coinsurance for existing preventive 
health benefits. 
Sec. 302. Coverage of initial preventive physical examination. 
Sec. 303. Promotion of preventive health benefits. 
TITLE IV—NATIONAL FALLS PREVENTION EDUCATION AND 
AWARENESS CAMPAIGN 
Sec. 401. National Falls Prevention Education and Awareness Campaign.
SEC. 2. DEFINITIONS. 
In this Act: 
(1) 
MEDICARE
BENEFICIARY.—The 
term 
‘‘medicare beneficiary’’ means any individual who is 
entitled to benefits under part A or enrolled under 
part B of the medicare program, including any indi-
vidual enrolled in a Medicare+Choice plan offered 
by a Medicare+Choice organization under part C of 
such program. 
(2) MEDICARE PROGRAM.—The term ‘‘medicare 
program’’ means the health benefits program under 
title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.). 
(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
TITLE I—HEALTHY SENIORS 
PROMOTION PROGRAM 
SEC. 101. DEFINITIONS. 
In this title: 
(1) 
COST-EFFECTIVE
BENEFIT.—The 
term 
‘‘cost-effective benefit’’ means a benefit or technique 
that has—
(A) been subject to peer review; 
(B) been described in scientific journals; 
and 
(C) demonstrated value as measured by 
unit costs relative to health outcomes achieved. 
(2) COST-SAVING BENEFIT.—The term ‘‘cost-
saving benefit’’ means a benefit or technique that 
has—
(A) been subject to peer review;
(B) been described in scientific journals; 
and 
(C) caused a net reduction in health care 
costs for medicare beneficiaries. 
(3) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means an entity that the Working Group (as de-
fined in paragraph (6)) determines has dem-
onstrated expertise regarding health promotion and 
disease prevention among medicare beneficiaries. 
(4) MEDICALLY EFFECTIVE.—The term ‘‘medi-
cally effective’’ means, with respect to a benefit or 
technique, that the benefit or technique has been—
(A) subject to peer review; 
(B) described in scientific journals; and 
(C) determined to achieve an intended goal 
under normal programmatic conditions. 
(5) 
MEDICALLY
EFFICACIOUS.—The 
term 
‘‘medically efficacious’’ means, with respect to a ben-
efit or technique, that the benefit or technique has 
been—
(A) subject to peer review; 
(B) described in scientific journals; and 
(C) determined to achieve an intended goal 
under controlled conditions.
(6) WORKING
GROUP.—The term ‘‘Working 
Group’’ means the Working Group on Disease Self-
Management and Health Promotion established 
under section 102. 
SEC. 102. WORKING GROUP ON DISEASE SELF-MANAGE-
MENT AND HEALTH PROMOTION. 
(a) ESTABLISHMENT.—There is established within 
the Department of Health and Human Services a Working 
Group on Disease Self-Management and Health Pro-
motion. 
(b) COMPOSITION.—
(1) IN GENERAL.—Subject to paragraph (2), 
the Working Group shall be composed of 5 members 
as follows: 
(A) The Administrator of the Health Care 
Financing Administration. 
(B) The Director of the Centers for Dis-
ease Control and Prevention. 
(C) The Director of the Agency for 
Healthcare Research and Quality. 
(D) The Assistant Secretary for Aging. 
(E) The Director of the National Institutes 
of Health. 
(2) ALTERNATIVE MEMBERSHIP.—Any member 
of the Working Group described in a subparagraph
of paragraph (1) may appoint an individual who is 
an officer or employee of the Federal Government to 
serve as a member of the Working Group instead of 
the member described in such subparagraph. 
(c) DUTIES.—The duties of the Working Group are 
as follows: 
(1) HEALTHY SENIORS PROMOTION GRANTS.—
The Working Group shall establish general policies 
and criteria with respect to the functions of the Sec-
retary under section 103, including—
(A) priorities for the approval of applica-
tions submitted under subsection (c) of such 
section; 
(B) procedures for monitoring and evalu-
ating research efforts conducted under such 
section; and 
(C) such other matters relating to the 
grant program established under such section 
as are recommended by the Working Group and 
approved by the Secretary. 
(2) DISEASE SELF-MANAGEMENT DEMONSTRA-
TION PROJECTS.—The Working Group shall estab-
lish general policies and criteria with respect to the 
functions of the Secretary under section 104, includ-
ing—