I 
108TH CONGRESS 
1ST SESSION H. R. 3458
To amend titles XVIII and XIX of the Social Security Act to provide for 
coverage under the Medicare and Medicaid Programs of certain screening 
procedures for diabetic retinopathy, and to amend the Public Health 
Service Act to establish pilot programs to foster such screening, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 6, 2003
Mr. COOPER introduced the following bill; which was referred to the Com-
mittee 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 provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
to provide for coverage under the Medicare and Medicaid 
Programs of certain screening procedures for diabetic 
retinopathy, and to amend the Public Health Service 
Act to establish pilot programs to foster such screening, 
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 ‘‘Diabetic Retinopathy 
Prevention Act of 2003’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) Type 2 diabetes affects 17,000,000 Ameri-
cans, with over 1,000,000 new cases diagnosed each 
year, 
and 
costs 
the 
Nation 
an 
estimated 
$138,000,000,000 per year. 
(2) Diabetic retinopathy is the most common 
complication resulting from diabetes, and causes 
degradation in visual acuity and eventual blindness. 
Diabetic retinopathy is the leading cause of blind-
ness in people aged 20 to 74, and up to 24,000 dia-
betics become legally blind each year. 
(3) Most individuals with diabetes will ulti-
mately develop diabetic retinopathy, and the risk of 
diabetic retinopathy increases with the duration of 
diabetes. Onset of type 2 diabetes is today occurring 
at younger ages, which will increase the prevalence 
of diabetic retinopathy in the future. 
(4) Clinical trials have demonstrated that early 
detection and treatment of diabetic retinopathy can 
reduce vision loss by 90 percent, and remote assess-
ment of diabetic retinopathy has the potential to 
reach large numbers of diabetic patients who live in
rural, remote or underserved areas and who lack 
geographical or financial access to regular, in-office 
eye examinations by eye specialists. 
SEC. 3. MEDICARE COVERAGE OF REMOTE ASSESSMENT OF 
DIABETIC RETINOPATHY. 
(a) COVERAGE.—Section 1861 of the Social Security 
Act (42 U.S.C. 1395x) is amended—
(1) in paragraph (s)(1)—
(A) in subparagraph (U), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (V)(iii), by adding 
‘‘and’’ at the end; and 
(C) by inserting after subparagraph (V) 
the following new subparagraph: 
‘‘(W) remote assessment of diabetic retinopathy 
(as defined in subsection (ww));’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘Remote Assessment of Diabetic Retinopathy 
‘‘(ww) The term ‘remote assessment of diabetic ret-
inopathy’ means a diagnostic examination of the retina for 
the purpose of early detection of diabetic retinopathy 
that—