SEC. 3. TAX CREDIT TO EMPLOYERS FOR COSTS OF IMPLE-
MENTING PREVENTION AND WELLNESS PRO-
GRAMS. 
(a) IN GENERAL.—Subpart D of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
1986 (relating to business related credits) is amended by 
adding at the end the following: 
‘‘SEC. 45R. PREVENTION AND WELLNESS PROGRAM CRED-
IT. 
‘‘(a) ALLOWANCE OF CREDIT.— 
‘‘(1) IN GENERAL.—For purposes of section 38, 
the prevention and wellness credit determined under 
this section for any taxable year during the credit 
period with respect to an employer is an amount 
equal to 50 percent of the costs paid or incurred by 
the employer in connection with a qualified preven-
tion and wellness during the taxable year. For pur-
poses of the preceding sentence, in the case of any 
qualified prevention and wellness offered as part of 
an employer-provided group health plan, including 
health insurance offered in connection with such 
plan, only costs attributable to the qualified preven-
tion and wellness and not to the group health plan 
or health insurance coverage may be taken into ac-
count.
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‘‘(2) LIMITATION.—The amount of credit al-
lowed under paragraph (1) for any taxable year shall 
not exceed the sum of— 
‘‘(A) the product of $200 and the number 
of employees of the employer not in excess of 
200 employees, plus 
‘‘(B) the product of $100 and the number 
of employees of the employer in excess of 200 
employees. 
‘‘(b) QUALIFIED PREVENTION AND WELLNESS.—For 
purposes of this section— 
‘‘(1) 
QUALIFIED
PREVENTION
AND 
WELLNESS.—The term ‘qualified prevention and 
wellness’ means a program which— 
‘‘(A) consists of any 3 of the prevention 
and wellness components described in sub-
section (c), and 
‘‘(B) which is certified by the Secretary of 
Health and Human Services, in coordination 
with the Director of the Center for Disease 
Control and Prevention, as a qualified preven-
tion and wellness under this section. 
‘‘(2) PROGRAMS MUST BE CONSISTENT WITH 
RESEARCH AND BEST PRACTICES.— 
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‘‘(A) IN
GENERAL.—The Secretary of 
Health and Human Services shall not certify a 
program as a qualified prevention and wellness 
unless the program— 
‘‘(i) is consistent with evidence-based 
research and best practices, as identified 
by persons with expertise in employer 
health promotion and prevention and 
wellnesss, 
‘‘(ii) includes multiple, evidence-based 
strategies which are based on the existing 
and emerging research and careful sci-
entific reviews, including the Guide to 
Community Preventive Services, the Guide 
to Clinical Preventive Services, and the 
National Registry for Effective Programs, 
and 
‘‘(iii) includes strategies which focus 
on employee populations with a dispropor-
tionate burden of health problems. 
‘‘(B) PERIODIC UPDATING AND REVIEW.— 
The Secretary of Health and Human Services 
shall establish procedures for periodic review of 
programs under this subsection. Such proce-
dures shall require revisions of programs if nec-
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essary to ensure compliance with the require-
ments of this section and require updating of 
the programs to the extent the Secretary, in co-
ordination with the Director of the Centers for 
Disease Control and Prevention, determines 
necessary to reflect new scientific findings. 
‘‘(3) HEALTH
LITERACY.—The Secretary of 
Health and Human Services shall, as part of the 
certification process, encourage employees to make 
the programs culturally competent and to meet the 
health literacy needs of the employees covered by the 
programs. 
‘‘(c) PREVENTION AND WELLNESS PROGRAM COM-
PONENTS.—For purposes of this section, the prevention 
and wellness components described in this subsection are 
the following: 
‘‘(1) HEALTH
AWARENESS
COMPONENT.—A 
health awareness component which provides for the 
following: 
‘‘(A) HEALTH EDUCATION.—The dissemi-
nation of health information which addresses 
the specific needs and health risks of employees. 
‘‘(B) HEALTH SCREENINGS.—The oppor-
tunity for periodic screenings for health prob-
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lems and referrals for appropriate follow up 
measures. 
‘‘(2) EMPLOYEE ENGAGEMENT COMPONENT.— 
An employee engagement component which provides 
for— 
‘‘(A) the establishment of a committee to 
actively engage employees in worksite preven-
tion and wellnesss through worksite assess-
ments and program planning, delivery, evalua-
tion, and improvement efforts, and 
‘‘(B) the tracking of employee participa-
tion. 
‘‘(3) BEHAVIORAL
CHANGE
COMPONENT.—A 
behavioral change component which provides for al-
tering employee lifestyles to encourage healthy living 
through counseling, seminars, on-line programs, or 
self-help materials which provide technical assistance 
and problem solving skills. Such component may in-
clude programs relating to— 
‘‘(A) tobacco use, 
‘‘(B) obesity, 
‘‘(C) stress management, 
‘‘(D) physical fitness, 
‘‘(E) nutrition, 
‘‘(F) substance abuse, 
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‘‘(G) depression, and 
‘‘(H) mental health promotion (including 
anxiety). 
‘‘(4) 
SUPPORTIVE
ENVIRONMENT
COMPO-
NENT.—A supportive environment component which 
includes the following: 
‘‘(A) ON-SITE
POLICIES.—Policies and 
services at the worksite which promote a 
healthy lifestyle, including policies relating to— 
‘‘(i) tobacco use at the worksite, 
‘‘(ii) the nutrition of food available at 
the worksite through cafeterias and vend-
ing options, 
‘‘(iii) minimizing stress and promoting 
positive mental health in the workplace, 
‘‘(iv) where applicable, accessible and 
attractive stairs, and 
‘‘(v) the encouragement of physical 
activity before, during, and after work 
hours. 
‘‘(B) PARTICIPATION INCENTIVES.— 
‘‘(i) IN GENERAL.—Qualified incentive 
benefits for each employee who participates 
in the health screenings described in para-
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subsection merely because the employer provides 
specialized programs for employees with specific 
health needs or unusual employment requirements or 
provides a pilot program to test new wellness strate-
gies. 
‘‘(2) QUALIFIED EMPLOYEE.—For purposes of 
paragraph 
(1), 
the 
term 
‘qualified 
employee’ 
means— 
‘‘(A) for employers offering health insur-
ance coverage, an employee who is eligible for 
such coverage, or 
‘‘(B) for employers not offering health in-
surance coverage, an employee who works an 
average of not less than 25 hours per week dur-
ing the taxable year. 
‘‘(e) OTHER DEFINITIONS AND SPECIAL RULES.— 
For purposes of this section— 
‘‘(1) EMPLOYEE AND EMPLOYER.— 
‘‘(A) PARTNERS
AND
PARTNERSHIPS.— 
The term ‘employee’ includes a partner and the 
term ‘employer’ includes a partnership. 
‘‘(B) CERTAIN RULES TO APPLY.—Rules 
similar to the rules of section 52 shall apply. 
‘‘(2) CERTAIN
COSTS
NOT
INCLUDED.—Costs 
paid or incurred by an employer for food or health 
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insurance shall not be taken into account under sub-
section (a). 
‘‘(3) NO CREDIT WHERE GRANT AWARDED.— 
No credit shall be allowable under subsection (a) 
with respect to any qualified prevention and wellness 
of any taxpayer (other than an eligible employer de-
scribed in subsection (f)(2)(A)) who receives a grant 
provided by the United States, a State, or a political 
subdivision of a State for use in connection with 
such program. The Secretary shall prescribe rules 
providing for the waiver of this paragraph with re-
spect to any grant which does not constitute a sig-
nificant portion of the funding for the qualified pre-
vention and wellness. 
‘‘(4) CREDIT PERIOD.— 
‘‘(A) IN GENERAL.—The term ‘credit pe-
riod’ means the period of 10 consecutive taxable 
years beginning with the taxable year in which 
the qualified prevention and wellness is first 
certified under this section. 
‘‘(B) SPECIAL RULE FOR EXISTING PRO-
GRAMS.—In the case of an employer (or prede-
cessor) which operates a prevention and 
wellness for its employees on the date of the en-
actment of this section, subparagraph (A) shall 
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be applied by substituting ‘3 consecutive taxable 
years’ for ‘10 consecutive taxable years’. The 
Secretary shall prescribe rules under which this 
subsection shall not apply if an employer is re-
quired to make substantial modifications in the 
existing prevention and wellness in order to 
qualify such program for certification as a 
qualified prevention and wellness. 
‘‘(C) CONTROLLED
GROUPS.—For pur-
poses of this paragraph, all persons treated as 
a single employer under subsection (b), (c), 
(m), or (o) of section 414 shall be treated as a 
single employer. 
‘‘(f) PORTION OF CREDIT MADE REFUNDABLE.— 
‘‘(1) IN GENERAL.—In the case of an eligible 
employer of an employee, the aggregate credits al-
lowed to a taxpayer under subpart C shall be in-
creased by the lesser of— 
‘‘(A) the credit which would be allowed 
under this section without regard to this sub-
section and the limitation under section 38(c), 
or 
‘‘(B) the amount by which the aggregate 
amount of credits allowed by this subpart (de-
termined without regard to this subsection) 
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would increase if the limitation imposed by sec-
tion 38(c) for any taxable year were increased 
by the amount of employer payroll taxes im-
posed on the taxpayer during the calendar year 
in which the taxable year begins. 
The amount of the credit allowed under this sub-
section shall not be treated as a credit allowed under 
this subpart and shall reduce the amount of the 
credit otherwise allowable under subsection (a) with-
out regard to section 38(c). 
‘‘(2) ELIGIBLE
EMPLOYER.—For purposes of 
this subsection, the term ‘eligible employer’ means 
an employer which is— 
‘‘(A) a State or political subdivision there-
of, the District of Columbia, a possession of the 
United States, or an agency or instrumentality 
of any of the foregoing, or 
‘‘(B) any organization described in section 
501(c) of the Internal Revenue Code of 1986 
which is exempt from taxation under section 
501(a) of such Code. 
‘‘(3) EMPLOYER
PAYROLL
TAXES.—For pur-
poses of this subsection— 
‘‘(A) IN
GENERAL.—The term ‘employer 
payroll taxes’ means the taxes imposed by— 
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‘‘(i) section 3111(b), and 
‘‘(ii) sections 3211(a) and 3221(a) 
(determined at a rate equal to the rate 
under section 3111(b)). 
‘‘(B) SPECIAL
RULE.—A rule similar to 
the rule of section 24(d)(2)(C) shall apply for 
purposes of subparagraph (A). 
‘‘(g) TERMINATION.—This section shall not apply to 
any amount paid or incurred after December 31, 2017.’’. 
(b) TREATMENT AS GENERAL BUSINESS CREDIT.— 
Subsection (b) of section 38 of the Internal Revenue Code 
of 1986 (relating to general business credit) is amended 
by striking ‘‘plus’’ at the end of paragraph (34), by strik-
ing the period at the end of paragraph (35) and inserting 
‘‘, plus’’, and by adding at the end the following: 
‘‘(36) the prevention and wellness credit deter-
mined under section 45R.’’. 
(c) DENIAL OF DOUBLE BENEFIT.—Section 280C of 
the Internal Revenue Code of 1986 (relating to certain 
expenses for which credits are allowable) is amended by 
adding at the end the following new subsection: 
‘‘(g) PREVENTION AND WELLNESS PROGRAM CRED-
IT.— 
‘‘(1) IN GENERAL.—No deduction shall be al-
lowed for that portion of the costs paid or incurred 
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for a qualified prevention and wellness (within the 
meaning of section 45R) allowable as a deduction for 
the taxable year which is equal to the amount of the 
credit allowable for the taxable year under section 
45R. 
‘‘(2) SIMILAR
RULE
WHERE
TAXPAYER
CAP-
ITALIZES RATHER THAN DEDUCTS EXPENSES.—If— 
‘‘(A) the amount of the credit determined 
for the taxable year under section 45R, exceeds 
‘‘(B) the amount allowable as a deduction 
for such taxable year for a qualified prevention 
and wellness, 
the amount chargeable to capital account for the 
taxable year for such expenses shall be reduced by 
the amount of such excess. 
‘‘(3) CONTROLLED GROUPS.—In the case of a 
corporation which is a member of a controlled group 
of corporations (within the meaning of section 
41(f)(5)) or a trade or business which is treated as 
being under common control with other trades or 
business 
(within 
the 
meaning 
of 
section 
41(f)(1)(B)), this subsection shall be applied under 
rules prescribed by the Secretary similar to the rules 
applicable under subparagraphs (A) and (B) of sec-
tion 41(f)(1).’’. 
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(d) CLERICAL AMENDMENT.—The table of sections 
for subpart D of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 is amended by add-
ing at the end the following: 
‘‘Sec. 45R. Prevention and wellness program credit.’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2009. 
(f) OUTREACH.— 
(1) IN GENERAL.—The Secretary of the Treas-
ury, in conjunction with the Director of the Centers 
for Disease Control and members of the business 
community, shall institute an outreach program to 
inform businesses about the availability of the pre-
vention and wellness credit under section 45R of the 
Internal Revenue Code of 1986 as well as to educate 
businesses on how to develop programs according to 
recognized and promising practices and on how to 
measure the success of implemented programs. 
(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated such sums 
as are necessary to carry out the outreach program 
described in paragraph (1). 
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SEC. 4. GRANTS TO INCREASE PHYSICAL ACTIVITY AND 
EMOTIONAL 
WELLNESS, 
IMPROVE 
NUTRI-
TION, AND PROMOTE HEALTHY EATING BE-
HAVIORS. 
Part Q of title III of the Public Health Service Act 
(42 U.S.C. 280h et seq.) is amended by striking section 
399W and inserting the following: 
‘‘SEC. 399W. GRANTS TO INCREASE PHYSICAL ACTIVITY 
AND EMOTIONAL WELLNESS, IMPROVE NU-
TRITION, AND PROMOTE HEALTHY EATING 
BEHAVIORS AND HEALTHY LIVING. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention and in coordination with the 
Administrator of the Health Resources and Services 
Administration, the Director of the Indian Health 
Service, the Secretary of Education, the Secretary of 
Agriculture, the Secretary of the Interior, the Direc-
tor of the National Institutes of Health, the Director 
of the Office of Women’s Health, and the heads of 
other appropriate agencies, shall award competitive 
grants to eligible entities to plan and implement pre-
vention and wellness programs that promote health 
and wellness and prevent chronic disease. Such 
grants may be awarded to target at-risk populations 
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including youth, health disparity populations (as de-
fined in section 485E(d)), and the underserved. 
‘‘(2) TERM.—The Secretary shall award grants 
under this subsection for a period not to exceed 4 
years. 
‘‘(b) AWARD OF GRANTS.—An eligible entity desiring 
a grant under this section shall submit an application to 
the Secretary at such time, in such manner, and con-
taining such information as the Secretary may require, in-
cluding— 
‘‘(1) a plan describing a comprehensive pro-
gram of approaches to encourage healthy living, 
emotional wellness, healthy eating behaviors, and 
healthy levels of physical activity; 
‘‘(2) the manner in which the eligible entity will 
coordinate with appropriate State and local authori-
ties and community-based organizations, including 
but not limited to— 
‘‘(A) State and local educational agencies; 
‘‘(B) departments of health; 
‘‘(C) State directors of programs under 
section 17 of the Child Nutrition Act of 1966 
(42 U.S.C. 1786); and 
‘‘(D) community-based organizations serv-
ing youth; and 
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‘‘(3) the manner in which the applicant will 
evaluate the effectiveness of the program carried out 
under this section. 
‘‘(c) COORDINATION.—In awarding grants under this 
section, the Secretary shall ensure that the proposed pro-
grams show a history of addressing these issues, have pro-
gram evaluations that show success, and are coordinated 
in substance and format with programs currently funded 
through other Federal agencies and operating within the 
community. 
‘‘(d) ELIGIBLE ENTITY.—In this section, the term 
‘eligible entity’ means— 
‘‘(1) a city, county, tribe, territory, or State; 
‘‘(2) a State educational agency; 
‘‘(3) a tribal educational agency; 
‘‘(4) a local educational agency; 
‘‘(5) a federally qualified health center (as de-
fined in section 1861(aa)(4) of the Social Security 
Act); 
‘‘(6) a rural health clinic; 
‘‘(7) a health department; 
‘‘(8) an Indian Health Service hospital or clinic; 
‘‘(9) an Indian tribal health facility; 
‘‘(10) an urban Indian facility; 
‘‘(11) any health provider; 
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‘‘(12) an accredited university or college; 
‘‘(13) a youth serving organization; 
‘‘(14) a community-based organization; or 
‘‘(15) any other entity determined appropriate 
by the Secretary. 
‘‘(e) USE OF FUNDS.—An eligible entity that receives 
a grant under this section shall use the funds made avail-
able through the grant to plan and implement prevention 
and wellness programs that promote health and wellness 
and prevent chronic disease. 
‘‘(f) MATCHING FUNDS.—In awarding grants under 
subsection (a), the Secretary may give priority to eligible 
entities who provide matching contributions. Such non- 
Federal contributions may be cash or in-kind, fairly evalu-
ated, including plant, equipment, training, curriculum, or 
a preexisting evaluation framework. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary may 
set aside an amount not to exceed 10 percent of the total 
amount appropriated for a fiscal year under subsection (j) 
to permit the Director of the Centers for Disease Control 
and Prevention to provide grantees with technical support 
in the development, implementation, and evaluation of pre-
vention and wellness programs under this section and to 
disseminate information about effective strategies and 
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interventions in promoting health and wellness and pre-
venting chronic disease. 
‘‘(h) LIMITATION ON ADMINISTRATIVE COSTS.—An 
eligible entity awarded a grant under this section may not 
use more than 10 percent of funds awarded under such 
grant for administrative expenses. 
‘‘(i) REPORT.—Not later than 6 years after the date 
of enactment of this section the Director of the Centers 
for Disease Control and Prevention shall review the results 
of the grants awarded under this section and other related 
research and identify prevention and wellness programs 
that have demonstrated effectiveness in promoting health 
and wellness and preventing chronic disease. Such review 
shall include an identification of model curricula, best 
practices, and lessons learned, as well as recommendations 
for next steps to promote health and wellness and prevent 
chronic disease. Information derived from such review, in-
cluding model prevention and wellness program curricula, 
shall be disseminated to the public. 
‘‘(j) DEFINITION.—In this section, the term ‘preven-
tion and wellness program’ means a program that consists 
of a combination of activities that are designed to increase 
awareness, assess risks, educate, and promote voluntary 
behavior change to improve the health of an individual, 
modify his or her consumer health behavior, enhance his 
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or her personal well-being and productivity, and prevent 
illness and injury. 
‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
$60,000,000 for fiscal year 2010, and such sums as may 
be necessary for each of fiscal years 2011 through 2014.’’. 
SEC. 5. PREVENTION AND WELLNESS PROGRAMS FOR INDI-
VIDUALS AND FAMILIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall encourage States to work with in-
surance companies on ways to promote and incentivize the 
participation of individuals and families in prevention and 
wellness programs, such as through insurance premium 
reductions. 
(b) DEFINITION.—In this section, the term ‘‘preven-
tion and wellness program’’ means a program that con-
sists of a combination of activities that are designed to 
increase awareness, assess risks, educate, and promote 
voluntary behavior change to improve the health of an in-
dividual, modify his or her consumer health behavior, en-
hance his or her personal well-being and productivity, and 
prevent illness and injury. 
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SEC. 6. RECOGNIZING FOR WELLNESS PROGRAMS UNDER 
GROUP HEALTH PLANS. 
(a) PUBLIC HEALTH SERVICE ACT.—Section 2702 of 
the Public Health Service Act (42 U.S.C. 300gg–1) is 
amended— 
(1) in subsection (b), by adding at the end the 
following new paragraph: 
‘‘(4) TREATMENT OF WELLNESS PROGRAMS.— 
Paragraph (1) shall not be construed as permitting 
variation of premiums based on adherence to or par-
ticipation in reasonably designed programs of health 
promotion and disease prevention, if such programs 
exist and a group health plan (or health insurance 
coverage offered in connection with such a plan) 
may establish premium discounts or rebates for 
modifying 
otherwise 
applicable 
copayments 
or 
deductibles in return for adherence to or participa-
tion in such programs.’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(g) PROGRAMS OF HEALTH PROMOTION OR DIS-
EASE PREVENTION.— 
‘‘(1) GENERAL PROVISIONS.— 
‘‘(A) GENERAL
RULE.—For purposes of 
this section, a program of health promotion or 
disease prevention (referred to in this sub-
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section as a ‘wellness program’) shall be a pro-
gram that is designed to promote health or pre-
vent disease that meets the applicable require-
ments of this subsection. 
‘‘(B) NO CONDITIONS BASED ON HEALTH 
STATUS FACTOR.—If none of the conditions for 
obtaining a premium discount or rebate or 
other reward for participation in a wellness pro-
gram is based on an individual satisfying a 
standard that is related to a health status fac-
tor, such wellness program shall not violate this 
section if participation in the program is made 
available to all similarly situated individuals 
and the requirements of paragraph (2) are com-
plied with. 
‘‘(C) CONDITIONS BASED ON HEALTH STA-
TUS FACTOR.—If any of the conditions for ob-
taining a premium discount or rebate or other 
reward for participation in a wellness program 
is based on an individual satisfying a standard 
that is related to a health status factor, such 
wellness program shall not violate this section if 
the requirements of paragraph (3) are complied 
with. 
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‘‘(2) WELLNESS PROGRAMS NOT SUBJECT TO 
REQUIREMENTS.—If none of the conditions for ob-
taining a premium discount or rebate or other re-
ward under a wellness program as described in para-
graph (1)(B) are based on an individual satisfying 
a standard that is related to a health status factor 
(or if such a wellness program does not provide such 
a reward), the wellness program shall not violate 
this section if participation in the program is made 
available to all similarly situated individuals. The 
following programs shall not have to comply with the 
requirements of paragraph (3) if participation in the 
program is made available to all similarly situated 
individuals: 
‘‘(A) A program that reimburses all or 
part of the cost for memberships in a fitness 
center. 
‘‘(B) A diagnostic testing program that 
provides a reward for participation and does 
not base any part of the reward on outcomes. 
‘‘(C) A program that encourages preven-
tive care related to a health condition through 
the waiver of the copayment or deductible re-
quirement under an individual or group health 
plan for the costs of certain items or services 
VerDate Nov 24 2008 
23:35 Aug 04, 2009
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E:\BILLS\H3468.IH
H3468
jbell on DSKDVH8Z91PROD with BILLS