I 
111TH CONGRESS 
1ST SESSION H. R. 1402 
To catalyze change in the care and treatment of diabetes in the United 
States. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 9, 2009 
Mr. SPACE (for himself, Ms. DEGETTE, Mr. TERRY, Mr. CASTLE, Mr. MAN-
ZULLO, and Mr. BRALEY of Iowa) introduced the following bill; which was 
referred to the Committee on Energy and Commerce 
A BILL 
To catalyze change in the care and treatment of diabetes 
in the United States. 
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; FINDINGS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Catalyst to Better Diabetes Care Act of 2009’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents; findings. 
Sec. 2. Diabetes screening collaboration and outreach program. 
Sec. 3. Advisory group regarding employee wellness and disease management 
best practices. 
Sec. 4. National Diabetes Report Card. 
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Sec. 5. Improvement of vital statistics collection. 
Sec. 6. Study on appropriate level of diabetes medical education. 
(c) FINDINGS.—The Congress finds as follows: 
(1) Diabetes is a chronic public health problem 
in the United States that is getting worse. 
(2) According to the Centers for Disease Con-
trol and Prevention: 
(A) One in 3 Americans born in 2000 will 
get diabetes. 
(B) One in 2 Hispanic females born in 
2000 will get diabetes. 
(C) 1,500,000 new cases of diabetes were 
diagnosed in adults in 2005. 
(D) In 2007, 23,600,000 Americans had 
diabetes, which is 7.8 percent of the population 
of the United States. 
(E) 5,700,000 Americans are currently 
undiagnosed. 
(F) African-Americans are nearly twice as 
likely as whites to have diabetes. 
(G) Nearly 13 percent of American Indians 
and Alaska Natives over 20 years old have diag-
nosed diabetes. 
(H) In States with significant Asian popu-
lations, Asians were 1.5 to 2 times as likely as 
whites to have diagnosed diabetes. 
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(C) Diabetes is the leading cause of new 
blindness in America, causing approximately 
12,000 to 24,000 new cases of blindness each 
year. 
(D) Diabetes is the leading cause of kidney 
failure in America, accounting for 44 percent of 
new cases in 2005. 
(E) In 2002, 44,400 Americans with dia-
betes began treatment for end-stage kidney dis-
ease and a total of 153,730 were living on 
chronic dialysis or with a kidney transplant as 
a result of their diabetes. 
(F) In 2004, approximately 71,000 ampu-
tations were performed on Americans with dia-
betes. 
(G) Poorly controlled diabetes before con-
ception and during the first trimester of preg-
nancy can cause major birth defects in 5 per-
cent to 10 percent of pregnancies and sponta-
neous abortions in 15 percent to 20 percent of 
pregnancies. 
(6) Diabetes is unique because many of its com-
plications and tremendous costs are largely prevent-
able through early detection, better education on di-
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abetes self-management, and improved delivery of 
available medical treatment: 
(A) 
According 
to 
the 
Agency 
for 
Healthcare Research and Quality, appropriate 
primary care for diabetes complications could 
have saved the Medicare and Medicaid pro-
grams $2,500,000,000 in hospital costs in 2001 
alone. 
(B) According to the Diabetes Prevention 
Project sponsored by the National Institutes of 
Health, lifestyle interventions such as diet and 
moderate physical activity for those with 
prediabetes reduced the development of diabetes 
by 58 percent; among Americans aged 60 and 
over, lifestyle interventions reduced diabetes by 
71 percent. 
(C) Research shows detecting and treating 
diabetic eye disease can reduce the development 
of severe vision loss by 50 percent to 60 per-
cent. 
(D) Research shows comprehensive foot 
care programs can reduce amputation rates by 
45 percent to 85 percent. 
(E) Detecting and treating early diabetic 
kidney disease by lowering blood pressure can 
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reduce the decline in kidney function by 30 per-
cent. 
(7) Research shows that diabetes self manage-
ment training (DSMT) programs, involving a health 
team approach that includes certified diabetes edu-
cators (CDEs), not only significantly reduces overall 
health costs but also improves health outcomes. 
SEC. 2. DIABETES SCREENING COLLABORATION AND OUT-
REACH PROGRAM. 
(a) ESTABLISHMENT.—With respect to diabetes 
screening tests and for the purposes of reducing the num-
ber of undiagnosed seniors with diabetes or prediabetes, 
the Secretary of Health and Human Services (referred to 
in this Act as the ‘‘Secretary’’), in collaboration with the 
Director of the Centers for Disease Control and Preven-
tion (referred to in this section as the ‘‘Director’’), shall— 
(1) review uptake and utilization of diabetes 
screening benefits to identify and address any exist-
ing problems with regard to utilization and data col-
lection mechanisms; 
(2) establish an outreach program to identify 
existing efforts by agencies and by the private and 
nonprofit sectors to increase awareness among sen-
iors and providers of diabetes screening benefits; and 
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(3) maximize cost effectiveness in increasing 
utilization of diabetes screening benefits. 
(b) CONSULTATION.—In carrying out this section, 
the Secretary and the Director shall consult with— 
(1) various units of the Federal Government, 
including the Centers for Medicare & Medicaid Serv-
ices, the Surgeon General of the Public Health Serv-
ice, the Agency for Healthcare Research and Qual-
ity, the Health Resources and Services Administra-
tion, and the National Institutes of Health; and 
(2) entities with an interest in diabetes, includ-
ing industry, voluntary health organizations, trade 
associations, and professional societies. 
SEC. 
3. 
ADVISORY 
GROUP 
REGARDING 
EMPLOYEE 
WELLNESS AND DISEASE MANAGEMENT BEST 
PRACTICES. 
(a) ESTABLISHMENT.—The Secretary shall establish 
an advisory group consisting of representatives of the pub-
lic and private sector. The advisory group shall include— 
(1) representatives of the Department of Health 
and Human Services; 
(2) representatives of the Department of Com-
merce; and 
(3) members of the public, representatives of 
the private sector, and representatives of the small 
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business community, who have experience in diabetes 
or administering and operating employee wellness 
and disease management programs. 
(b) DUTIES.—The advisory group established under 
subsection (a) shall examine and make recommendations 
of best practices of employee wellness and disease manage-
ment programs in order to— 
(1) provide public and private sector entities 
with improved information in assessing the role of 
employee wellness and disease management pro-
grams in saving money and improving quality of life 
for patients with chronic illnesses; and 
(2) encourage the adoption of effective employee 
wellness and disease management programs. 
(c) REPORT.—Not later than 1 year after the date 
of the enactment of this Act, the advisory group estab-
lished under subsection (a) shall submit to the Secretary 
the results of the examination under subsection (b)(1). 
SEC. 4. NATIONAL DIABETES REPORT CARD. 
(a) IN GENERAL.—The Secretary, in collaboration 
with the Director of the Centers for Disease Control and 
Prevention (referred to in this section as the ‘‘Director’’), 
shall prepare on a biennial basis a national diabetes report 
card (referred to in this section as a ‘‘Report Card’’) and, 
to the extent possible, for each State. 
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