I 
112TH CONGRESS 
1ST SESSION H. R. 2741 
To amend title XVIII of the Social Security Act to reduce the occurrence 
of diabetes in Medicare beneficiaries by extending coverage under Medi-
care for medical nutrition therapy services to such beneficiaries with 
pre-diabetes or with risk factors for developing type 2 diabetes. 
IN THE HOUSE OF REPRESENTATIVES 
AUGUST 1, 2011 
Ms. DEGETTE (for herself and Mr. WHITFIELD) 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 subse-
quently 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 occurrence of diabetes in Medicare beneficiaries by 
extending coverage under Medicare for medical nutrition 
therapy services to such beneficiaries with pre-diabetes 
or with risk factors for developing type 2 diabetes. 
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 ‘‘Preventing Diabetes 
in Medicare Act of 2011’’. 
VerDate Mar 15 2010 
23:10 Aug 02, 2011
Jkt 099200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H2741.IH
H2741
emcdonald on DSK2BSOYB1PROD with BILLS
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) According to the Centers for Disease Con-
trol and Prevention (CDC), there are 79,000,000 
adults with pre-diabetes in America. The CDC esti-
mates that 50 percent of adults ages 65 and older 
have pre-diabetes. More than 90 percent of adults 
with pre-diabetes are unaware they have it. 
(2) For a significant number of people with 
pre-diabetes, early intervention can reverse elevated 
blood glucose levels to normal range and prevent di-
abetes and its complications completely or can sig-
nificantly delay its onset. According to the Institute 
for Alternative Futures (IAF), if 50 percent of 
adults with pre-diabetes were able to successfully 
make lifestyle changes proven to prevent or delay di-
abetes, then by 2025 approximately 4,700,000 new 
cases of diabetes could be prevented at a cost sav-
ings of $300 billion. 
(3) Diabetes-related hospitalizations totaled 
24.3 million days in 2007, an increase of 7.4 million 
days from the 16.9 million days in 2002. 
(4) Preventing diabetes and its complications 
can save money and lives. The average annual cost 
to treat someone with diabetes is $11,744, compared 
to $2,935 for someone who does not have diabetes. 
VerDate Mar 15 2010 
23:10 Aug 02, 2011
Jkt 099200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H2741.IH
H2741
emcdonald on DSK2BSOYB1PROD with BILLS
(5) Diabetes is unique because its complications 
and their associated health care costs are often pre-
ventable with currently available medical treatment 
and lifestyle changes. 
(6) In 2002, the Diabetes Prevention Program 
study conducted by the National Institutes of Health 
found that participants (all of whom were at in-
creased risk of developing type 2 diabetes) who made 
lifestyle changes reduced their risk of developing 
type 2 diabetes by 58 percent and that participants 
aged 60 and older reduced their risk of developing 
diabetes by 71 percent. 
(7) The Agency for Healthcare Research and 
Quality 
(AHRQ) 
has 
demonstrated 
that 
$2,500,000,000 in hospitalization costs related to 
the treatment of diabetes or complications resulting 
from diabetes could be saved by providing seniors 
with appropriate primary care to prevent the onset 
of diabetes. 
(8) The Medicare program currently provides 
coverage for screening and identifying beneficiaries 
with pre-diabetes but does not provide adequate 
services to such beneficiaries to help them prevent or 
delay the onset of diabetes. 
VerDate Mar 15 2010 
23:10 Aug 02, 2011
Jkt 099200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H2741.IH
H2741
emcdonald on DSK2BSOYB1PROD with BILLS
SEC. 3. MEDICARE COVERAGE OF MEDICAL NUTRITION 
THERAPY SERVICES FOR PEOPLE WITH PRE- 
DIABETES AND RISK FACTORS FOR DEVEL-
OPING TYPE 2 DIABETES. 
(a) IN GENERAL.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)(V), by striking ‘‘with 
diabetes or a renal disease’’ and inserting ‘‘with dia-
betes, pre-diabetes (as defined in subsection (yy)(4)), 
or a renal disease, or an individual at risk for diabe-
tes (as defined in subsection (yy)(2)),’’; and 
(2) in subsection (yy)— 
(A) in the heading, by adding ‘‘; Pre-Dia-
betes’’ at the end; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(4) The term ‘pre-diabetes’ means a condition of im-
paired fasting glucose or impaired glucose tolerance identi-
fied by a blood glucose level that is higher than normal, 
but not so high as to indicate actual diabetes.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to services furnished 
on or after January 1, 2012. 
Æ 
VerDate Mar 15 2010 
23:10 Aug 02, 2011
Jkt 099200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6301
E:\BILLS\H2741.IH
H2741
emcdonald on DSK2BSOYB1PROD with BILLS