I
107TH CONGRESS
1ST SESSION
H. R. 2058
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
JUNE 5, 2001
Mr. LEVIN (for himself, Mr. FOLEY, Mr. STARK, Mr. LEACH, Mr. ABER-
CROMBIE, Mr. BALDACCI, Mr. CARDIN, Mr. COYNE, Mr. CROWLEY, Ms.
DEGETTE, Mr. HINCHEY, Mr. HOEFFEL, Mr. HORN, Mr. KILDEE, Ms.
LEE, Mr. MCNULTY, Mr. PASTOR, Ms. ROYBAL-ALLARD, Mr. SANDERS,
Mr. SERRANO, Mr. SIMMONS, Mrs. THURMAN, and Mr. WAXMAN) intro-
duced the following bill; which was referred to the Committee on Energy
and Commerce, and in addition to the Committees on Ways and Means
and Rules, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the juris-
diction 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 2001’’.
(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 hearing impairment.
Sec. 205. Screening for cholesterol.
Sec. 206. Screening for hypertension.
Sec. 207. Expansion of eligibility for bone mass measurement.
Sec. 208. Coverage of medical nutrition therapy services for beneficiaries with
cardiovascular diseases.
Sec. 209. Elimination of deductibles and coinsurance for existing preventive
health benefits.
Sec. 210. Program integrity.
Sec. 211. Promotion of preventive health benefits.
TITLE III—NATIONAL FALLS PREVENTION EDUCATION AND
AWARENESS CAMPAIGN
Sec. 301. National falls prevention education and awareness campaign.
TITLE IV—CLINICAL DEPRESSION SCREENING DEMONSTRATION
PROJECTS
Sec. 401. Clinical depression screening demonstration projects.
TITLE V—MEDICARE HEALTH EDUCATION AND RISK APPRAISAL
PROGRAM
Sec. 501. Medicare health education and risk appraisal program.
TITLE VI—STUDIES, EVALUATIONS, AND REPORTS IN THE FIELD
OF DISEASE PREVENTION AND THE ELDERLY
Sec. 601. MedPAC evaluation and report on medicare benefit package in rela-
tion to private sector benefit packages.
Sec. 602. National Institute on Aging study and report on ways to improve the
quality of life of elderly.
Sec. 603. Institute of Medicine medicare prevention benefit study and report.
Sec. 604. Fast-track consideration of prevention benefit legislation.
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,
including—
(A) the identification of medical conditions
for which a demonstration project under such
section may be implemented;
(B) the prioritization of the conditions
identified under subparagraph (A) based on the
potential for the self-management of such con-
dition to be medically effective and for such
self-management to be a cost-effective benefit
or cost-saving benefit;
(C) the identification of target individuals
(as defined in section 104(a)(2));
(D) the development of procedures for se-
lecting areas in which such a demonstration
project may be implemented; and
(E) such other matters relating to such
demonstration projects as are recommended by
the Working Group and approved by the Sec-
retary.
(d) CHAIRPERSON.—The Secretary shall designate 1
of the members of the Working Group to be the chair-
person of the Group.
(e) QUORUM.—A majority of the members of the
Working Group shall constitute a quorum, but, subject to
subsection (f), a lesser number of members may hold
meetings.
(f) MEETINGS.—The Working Group shall meet at
the call of the chairperson, except that—
(1) it shall meet not less than 4 times each
year; and
(2) it shall meet upon the written request of a
majority of the members.
(g) COMPENSATION OF MEMBERS.—Each member of
the Working Group shall serve without compensation in
addition to that received for their service as an officer or
employee of the Federal Government.
(h) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated such sums as may be
necessary for the purpose of carrying out this section.
SEC. 103. HEALTHY SENIORS PROMOTION GRANTS.
(a) PROGRAM AUTHORIZED.—The Secretary, using
the general policies and criteria established by the Work-
ing Group under section 102(c)(1) and in accordance with
the provisions of this section, is authorized to make grants
to eligible entities (as defined in section 101(3)) to pay
for the costs of the activities described in subsection (b).
(b) USE OF FUNDS.—An eligible entity may use pay-
ments received under this section in any fiscal year to con-
duct a program to—
(1) study whether using different types of pro-
viders of care and alternative settings (including
community-based senior centers) for the implemen-
tation of a successful health promotion and disease
prevention strategy, including the implications re-
garding the payment of such providers, is medically
efficacious or medically effective;
(2) determine the most effective means of edu-
cating medicare beneficiaries, either directly or
through providers of care, regarding the importance
of health promotion and disease prevention among
such beneficiaries;
(3) identify incentives that would increase the
use of new and existing preventive health benefits
and healthy behaviors by medicare beneficiaries;
(4) promote—
(A) the use of preventive health benefits by
medicare beneficiaries, including such services
that are covered under the medicare program;
(B) the proper use by medicare bene-
ficiaries of prescription and over-the-counter
drugs in order to reduce the number of hospital
stays and physician visits that are a result of
improper use of such drugs; and
(C) the utilization by medicare bene-
ficiaries of the steps (including exercise, mainte-
nance of a proper diet, and the utilization of ac-
cident prevention techniques) that research has
shown to promote and safeguard individual
health; and
(5) address other topics designated by the Sec-
retary.
(c) APPLICATION.—
(1) IN GENERAL.—Each eligible entity that de-
sires to receive a grant under this section shall sub-
mit an application to the Secretary, at such time, in
such manner, and accompanied by such additional
information as the Secretary may reasonably re-
quire.
(2) CONTENTS.—Each application submitted
under paragraph (1) shall—
(A) describe the activities for which assist-
ance under this section is sought;
(B) describe how such activities will—
(i) reflect the medical, behavioral, and
social aspects of care for medicare bene-
ficiaries;
(ii) lead to the development of cost-ef-
fective benefits and cost-saving benefits;
and
(iii) impact the quality of life of medi-
care beneficiaries;
(C) provide assurances that such activities
will focus on broad medicare populations rather
than unique local medicare populations;
(D) provide evidence that the eligible entity
meets the general policies and criteria estab-
lished by the Working Group under section
102(c)(1);
(E) provide assurances that the eligible en-
tity will take such steps as may be available to
the entity in order to continue the activities for
which the entity is making application after the
period for which assistance is sought; and
(F) provide such additional assurances as
the Secretary determines to be essential to en-
sure compliance with the requirements of this
title.
(3) JOINT APPLICATION.—A consortium of eli-
gible entities may file a joint application under the
provisions of paragraph (1).
(d) APPROVAL
OF APPLICATION.—The Secretary
shall approve applications in accordance with the general
policies and criteria established by the Working Group
under section 102(c)(1).
(e) PAYMENTS.—Subject to amounts appropriated
under subsection (g), the Secretary shall pay to each eligi-
ble entity having an application approved under subsection
(d) the cost of the activities described in the application.
(f) EVALUATION AND REPORT.—
(1) EVALUATION.—The Secretary shall conduct
an annual evaluation of grants made under this sec-
tion to determine—
(A) the results of the activities conducted
under the programs for which grants were
made under this section;
(B) the extent to which research assisted
under this section has improved or expanded
the general research for health promotion and
disease prevention among medicare beneficiaries
and identified practical interventions based
upon such research;
(C) a list of specific recommendations
based upon the activities conducted under the
programs for which grants were made under
this section which show promise as practical
interventions for health promotion and disease
prevention among medicare beneficiaries;
(D) whether or not, as a result of the ac-
tivities conducted under the programs for which
grants were made under this section, certain
health promotion and disease prevention bene-
fits or education efforts should be added to the
medicare program, including discussions of
quality of life, translating the applied research
results into a benefit under the medicare pro-
gram, and whether each additional benefit
would be a cost-effective benefit or a cost-saving
benefit for each proposed addition; and
(E) how best to increase utilization of ex-
isting and recommended health promotion and
disease prevention services, such as an edu-
cation and public awareness campaign, pro-
viding financial incentives for providers of care
and medicare beneficiaries, or utilizing other
administrative means.
(2) ANNUAL REPORT.—Not later than Decem-
ber 31, 2003, and annually thereafter through 2005,
the Secretary, in consultation with the Working
Group, shall submit a report to Congress on the
evaluation conducted under paragraph (1), together
with such recommendations for such legislation and
administrative actions as the Secretary considers ap-
propriate.
(g) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated for the purpose of car-
rying out this section $50,000,000 for each of fiscal years
2002, 2003, 2004, and 2005.
SEC. 104. DISEASE SELF-MANAGEMENT DEMONSTRATION
PROJECTS.
(a) DEMONSTRATION PROJECTS.—
(1) IN GENERAL.—The Secretary shall conduct
demonstration projects for the purpose of promoting
disease self-management for conditions identified by
the Working Group under section 102(c)(2) for tar-
get individuals (as defined in paragraph (2)).
(2) TARGET
INDIVIDUAL
DEFINED.—In this
section, the term ‘‘target individual’’ means an indi-
vidual who—
(A) is at risk for, or has, 1 or more of the
conditions identified by the Working Group
under section 102(c)(2); and
(B) is enrolled under the original medicare
fee-for-service program under parts A and B of
title XVIII of the Social Security Act (42
U.S.C. 1395c et seq.; 1395j et seq.) or is en-
rolled under the Medicare+Choice program
under part C of title XVIII of such Act (42
U.S.C. 1395w–21 et seq.).
(b) NUMBER; PROJECT AREAS; DURATION.—
(1) NUMBER.—Not later than 2 years after the
date of enactment of this Act, the Secretary shall
implement a series of demonstration projects to
carry out the purpose described in subsection (a)(1).
(2) PROJECT AREAS.—The Secretary shall im-
plement the demonstration projects described in
paragraph (1) in urban, suburban, and rural areas.
(3) DURATION.—The demonstration projects
under this section shall be conducted during the 3-
year period beginning on the date on which the ini-
tial demonstration project is implemented.
(c) REPORT TO CONGRESS.—
(1) IN GENERAL.—Not later than 18 months
after the conclusion of the demonstration projects
under this section, the Secretary shall submit a re-
port to Congress on such projects.
(2) CONTENTS
OF
REPORT.—The report re-
quired under paragraph (1) shall include the fol-
lowing:
(A) A description of the demonstration
projects.
(B) An evaluation of—
(i) whether each benefit provided
under the demonstration projects is a cost-
effective benefit or a cost-saving benefit;
(ii) the level of the disease self-man-
agement attained by target individuals
under the demonstration projects; and
(iii) the satisfaction of target individ-
uals under the demonstration projects.
(C) Recommendations of the Secretary re-
garding whether to conduct the demonstration
projects on a permanent basis.
(D) Such recommendations for legislation
and administrative action as the Secretary de-
termines to be appropriate.
(E) Any other information regarding the
demonstration projects that the Secretary de-
termines to be appropriate.
(d) FUNDING.—The Secretary shall provide for the
transfer from the Federal Hospital Insurance Trust Fund
under section 1817 of the Social Security Act (42 U.S.C.
1395i) an amount not to exceed $30,000,000 for the costs
of carrying out this section.
TITLE II—MEDICARE COVERAGE
OF 
PREVENTIVE 
HEALTH
BENEFITS
SEC. 201. THERAPY AND COUNSELING FOR CESSATION OF
TOBACCO USE.
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)), as amended by section
105(a) of the Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000 (114 Stat.
2763A–471), as enacted into law by section 1(a)(6) of
Public Law 106–554, is amended—
(1) in subparagraph (U), by striking ‘‘and’’ at
the end;
(2) in subparagraph (V), by inserting ‘‘and’’ at
the end; and
(3) by adding at the end the following new sub-
paragraph:
‘‘(W) supplemental preventive health services
(as defined in subsection (ww));’’.
(b) SERVICES DESCRIBED.—Section 1861 of the So-
cial Security Act (42 U.S.C. 1395x), as amended by sec-
tion 105(b) of the Medicare, Medicaid, and SCHIP Bene-
fits Improvement and Protection Act of 2000 (114 Stat.
2763A–471), as enacted into law by section 1(a)(6) of
Public Law 106–554, is amended by adding at the end
the following new subsection:
‘‘Supplemental Preventive Health Services
‘‘(ww) The term ‘supplemental preventive health serv-
ices’ means the following:
‘‘(1)(A) Therapy and counseling for cessation of
tobacco use for individuals who use tobacco products
or who are being treated for tobacco use that is
furnished—
‘‘(i) by or under the supervision of a physi-
cian; or
‘‘(ii) by any other health care professional
who—
‘‘(I) is legally authorized to furnish
such services under State law (or the State
regulatory mechanism provided by State
law) of the State in which the services are
furnished; and
‘‘(II) is authorized to receive payment
for other services under this title or is des-
ignated by the Secretary for this purpose.
‘‘(B) Subject to subparagraph (C), such term is
limited to—
‘‘(i) therapy and counseling services rec-
ommended in ‘Treating Tobacco Use and De-
pendence: A Clinical Practice Guideline’, pub-
lished by the Public Health Service in June
2000, or any subsequent modification of such
Guideline; and
‘‘(ii) such other therapy and counseling
services that the Secretary recognizes to be ef-
fective.
‘‘(C) Such term shall not include coverage for
drugs or biologicals that are not otherwise covered
under this title.’’.
(c) PAYMENT AND ELIMINATION OF COST-SHARING
FOR ALL SUPPLEMENTAL PREVENTIVE HEALTH SERV-
ICES.—
(1) PAYMENT AND ELIMINATION OF COINSUR-
ANCE.—Section 1833(a)(1) of the Social Security
Act (42 U.S.C. 1395l(a)(1)), as amended by section
223(c) of the Medicare, Medicaid, and SCHIP Bene-
fits Improvement and Protection Act of 2000 (114
Stat. 2763A–489), as enacted into law by section
1(a)(6) of Public Law 106–554, is amended—
(A) in subparagraph (N), by inserting
‘‘other than supplemental preventive health
services (as defined in section 1861(ww))’’ after
‘‘(as defined in section 1848(j)(3))’’
(B) by striking ‘‘and’’ before ‘‘(U)’’; and
(C) by inserting before the semicolon at
the end the following: ‘‘, and (V) with respect
to supplemental preventive health services (as
defined in section 1861(ww)), the amount paid
shall be 100 percent of the lesser of the actual
charge for the services or the amount deter-
mined under the payment basis determined
under section 1848 by the Secretary for the
particular supplemental preventive health serv-
ice involved’’.
(2) PAYMENT UNDER PHYSICIAN FEE SCHED-
ULE.—Section 
1848(j)(3) 
(42 
U.S.C. 
1395w–
4(j)(3)) is amended by inserting ‘‘(2)(W),’’ after
‘‘(2)(S),’’.
(3) ELIMINATION
OF
COINSURANCE
IN
OUT-
PATIENT HOSPITAL SETTINGS.—The third sentence
of section 1866(a)(2)(A) of the Social Security Act
(42 U.S.C. 1395cc(a)(2)(A)) is amended by insert-
ing after ‘‘1861(s)(10)(A)’’ the following: ‘‘, with re-
spect to supplemental preventive health services (as
defined in section 1861(ww)),’’.
(4) ELIMINATION OF DEDUCTIBLE.—The first
sentence of section 1833(b) of the Social Security
Act (42 U.S.C. 1395l(b)) is amended—
(A) by striking ‘‘and’’ before ‘‘(6)’’; and
(B) by inserting before the period the fol-
lowing: ‘‘, and (7) such deductible shall not
apply with respect to supplemental preventive
health 
services 
(as 
defined 
in 
section
1861(ww))’’.
(d) APPLICATION OF LIMITS ON BILLING.—Section
1842(b)(18)(C) of the Social Security Act (42 U.S.C.
1395u(b)(18)(C)), as amended by section 105(d) of the
Medicare, Medicaid, and SCHIP Benefits Improvement
and Protection Act of 2000 (114 Stat. 2763A–472), as
enacted into law by section 1(a)(6) of Public Law 106–
554, is amended by adding at the end the following new
clause:
‘‘(vii) Any health care professional designated
under section 1861(ww)(1)(A)(ii)(II) to perform
therapy and counseling for cessation of tobacco
use.’’.
(e) EFFECTIVE DATE.—The amendments made by
this section shall apply to services furnished on or after
the day that is 1 year after the date of enactment of this
Act.
SEC. 202. COUNSELING FOR POST-MENOPAUSAL WOMEN.
(a) COVERAGE.—Section 1861(ww) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)), as added by section
201(b), is amended by adding at the end the following new
paragraph:
‘‘(2)(A) 
Counseling 
for 
post-menopausal
women.
‘‘(B) For purposes of subparagraph (A), the
term ‘counseling for post-menopausal women’ means
counseling provided to a post-menopausal woman
regarding—
‘‘(i) the symptoms, risk factors, and condi-
tions associated with menopause;
‘‘(ii) appropriate treatment options for
post-menopausal women, including hormone re-
placement therapy; and
‘‘(iii) other interventions that can be imple-
mented to prevent or delay the onset of health
risks associated with menopause.
SEC. 204. SCREENING FOR HEARING IMPAIRMENT.
(a) COVERAGE.—Section 1861(ww) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)), as amended by section
203(a), is amended by adding at the end the following new
paragraph:
‘‘(4)(A) Screening for hearing impairment.
‘‘(B) For purposes of subparagraph (A), the
term ‘screening for hearing impairment’ means the
following services:
‘‘(i) A screening for hearing impairment
using periodic questions that is furnished by—
‘‘(I) 
a 
physician, 
including 
an
otolaryngologist;
‘‘(II) a qualified audiologist (as de-
fined in subsection (ll)(3)(B)); or
‘‘(III) any other health care profes-
sional who is legally authorized to furnish
such screening under State law (or the
State regulatory mechanism provided by
State law) of the State in which the
screening is furnished.
‘‘(ii) If the answers to such questions indi-
cate potential hearing impairment, an otoscopic
examination and an audiometric screening test
that are furnished by an otolaryngologist or a
qualified audiologist (as so defined).
‘‘(iii) If the results of such examination or
test indicate a need for assistive listening de-
vices (whether or not such examination or test
was based on a screening or was diagnostic),
counseling about such devices that is furnished
by an otolaryngologist or a qualified audiologist
(as so defined).’’.
(b) EFFECTIVE DATE.—The amendment made by
this section shall apply to services furnished on or after
the day that is 1 year after the date of enactment of this
Act.
SEC. 205. SCREENING FOR CHOLESTEROL.
(a) COVERAGE.—Section 1861(ww) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)), as amended by section
204(a), is amended by adding at the end the following new
paragraph:
‘‘(5)(A) Screening for cholesterol if the indi-
vidual involved has not had such a screening during
the preceding 5 years.
‘‘(B) Notwithstanding subparagraph (A), pay-
ment may be made under this part for a screening
for cholesterol with respect to an individual even if
the individual has had such a screening during the
preceding 5 years if the individual exhibits major
risk factors for coronary heart disease or a stroke,
including, but not limited to, smoking, hypertension,
and diabetes.’’.
(b) CONFORMING AMENDMENT.—Section 1862(a)(1)
of the Social Security Act (42 U.S.C. 1395y(a)(1)) is
amended—
(1) in subparagraph (H), by striking ‘‘and’’ at
the end;
(2) in subparagraph (I), by striking the semi-
colon at the end and inserting ‘‘, and’’; and
(3) by adding at the end the following new sub-
paragraph:
‘‘(J) in the case of a screening for choles-
terol, which is performed more frequently than
is covered under section 1861(ww)(5);’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to services furnished on or after
the day that is 1 year after the date of enactment of this
Act.
SEC. 206. SCREENING FOR HYPERTENSION.
(a) COVERAGE.—Section 1861(ww) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)), as amended by section
205(a), is amended by adding at the end the following new
paragraph:
‘‘(6)(A) Screening for hypertension if the indi-
vidual involved has not had such a screening during
the preceding 2 years.
‘‘(B) Notwithstanding subparagraph (A), pay-
ment may be made under this part for a screening
for hypertension with respect to an individual even
if the individual has had such a screening during the
preceding 2 years if the individual has a history of,
or is at risk for, hypertension.’’.
(b) CONFORMING AMENDMENT.—Section 1862(a)(1)
of the Social Security Act (42 U.S.C. 1395y(a)(1)), as
amended by section 205(b), is amended—
(1) in subparagraph (I), by striking ‘‘and’’ at
the end;
(2) in subparagraph (J), by striking the semi-
colon at the end and inserting ‘‘, and’’; and
(3) by adding at the end the following new sub-
paragraph:
‘‘(K) in the case of a screening for hyper-
tension, which is performed more frequently
than is covered under section 1861(ww)(6);’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to services furnished on or after
the day that is 1 year after the date of enactment of this
Act.
SEC. 207. EXPANSION OF ELIGIBILITY FOR BONE MASS
MEASUREMENT.
(a) EXPANSION.—Section 1861(rr)(2) of the Social
Security Act (42 U.S.C. 1395x(rr)(2)) is amended to read
as follows:
‘‘(2) For purposes of this subsection, the term ‘quali-
fied individual’ means an individual who is (in accordance
with regulations prescribed by the Secretary)—
‘‘(A) an estrogen-deficient woman (including
those receiving hormone replacement therapy);
‘‘(B) an individual with low trauma or fragility
fractures (including vertebral abnormalities and hip,
rib, wrist, pelvic, or proximal humeral fractures);
‘‘(C) an individual receiving long-term medica-
tions that have associations to bone loss or
osteoporosis (including glucocorticoid therapy and
androgen deprivation therapy);
‘‘(D) an individual with a long-term medical
condition that has association to osteoporosis (in-
cluding primary hyperparathyroidism);
‘‘(E) a man with risk factors for osteoporosis
such as hypogonadism; and
‘‘(F) an individual being monitored to assess
the response to, or efficacy of, an approved
osteoporosis therapy.’’.
(b) REFERENCE TO ELIMINATION OF COINSURANCE
AND WAIVER OF APPLICATION OF DEDUCTIBLE.—For
the elimination of the coinsurance for bone mass measure-
ment and for the waiver of the application of the part B
deductible for such measurement, see section 209.
(c) EFFECTIVE DATE.—The amendment made by
subsection (a) shall apply to services furnished on or after
the day that is 1 year after the date of enactment of this
Act.
SEC. 208. COVERAGE OF MEDICAL NUTRITION THERAPY
SERVICES FOR BENEFICIARIES WITH CAR-
DIOVASCULAR DISEASES.
(a) IN GENERAL.—Section 1861(s)(2)(V) of the So-
cial Security Act (42 U.S.C. 1395x(s)(2)(V)), as added by
subsection (a) of section 105 of the Medicare, Medicaid,
and SCHIP Benefits Improvement and Protection Act of
2000 (114 Stat. 2763A–471), as enacted into law by sec-
tion 1(a)(6) of Public Law 106–554, is amended to read
as follows:
‘‘(V) medical nutrition therapy services (as de-
fined in subsection (vv)(1)) in the case of a
beneficiary—
‘‘(i) with a cardiovascular disease (includ-
ing congestive heart failure, arteriosclerosis,
hyperlipidemia, 
hypertension, 
and
hypercholesterolemia), diabetes, or a renal dis-
ease (or a combination of such conditions)
who—
‘‘(I) has not received diabetes out-
patient self-management training services
within a time period determined by the
Secretary;
‘‘(II) is not receiving maintenance di-
alysis for which payment is made under
section 1881; and
‘‘(III) meets such other criteria deter-
mined by the Secretary after consideration
of protocols established by dietitian or nu-
trition professional organizations; or
‘‘(ii) with a combination of such conditions
who—
‘‘(I) is not described in clause (i) be-
cause of the application of subclause (I) or
(II) of such clause;
‘‘(II) receives such medical nutrition
therapy services in a coordinated manner
(as determined appropriate by the Sec-
retary) with any services described in such
subclauses that the beneficiary is receiving;
and
‘‘(III) meets such other criteria deter-
mined by the Secretary after consideration
of protocols established by dietitian or nu-
trition professional organizations;’’.
(b) 
ELIMINATION
OF
COINSURANCE.—Section
1833(a)(1)(T) of the Social Security Act (42 U.S.C.
1395l(a)(1)(T)), as added by section 105(c)(2) of the
Medicare, Medicaid, and SCHIP Benefits Improvement
and Protection Act of 2000 (114 Stat. 2763A–472), as
enacted into law by section 1(a)(6) of Public Law 106–
554, is amended by striking ‘‘80 percent’’ and inserting
‘‘100 percent’’.
(c) REFERENCE TO WAIVER OF APPLICATION OF DE-
DUCTIBLE.—For the waiver of the application of the part
B deductible for medical nutrition therapy services, see
section 209.
(d) EFFECTIVE DATE.—The amendments made by
this section shall take effect as if included in the enact-
ment of section 105 of the Medicare, Medicaid, and
SCHIP Benefits Improvement and Protection Act of 2000
(114 Stat. 2763A–471), as enacted into law by section
1(a)(6) of Public Law 106–554.
SEC. 209. ELIMINATION OF DEDUCTIBLES AND COINSUR-
ANCE FOR EXISTING PREVENTIVE HEALTH
BENEFITS.
(a) IN GENERAL.—Section 1833 of the Social Secu-
rity Act (42 U.S.C. 1395l) is amended by inserting after
subsection (o) the following new subsection:
‘‘(p) DEDUCTIBLES AND COINSURANCE WAIVED FOR
PREVENTIVE HEALTH ITEMS AND SERVICES.—The Sec-
retary may not require the payment of any deductible or
coinsurance under subsection (a) or (b), respectively, of
any individual enrolled for coverage under this part for
any of the following preventive health items and services:
‘‘(1) Blood-testing strips, lancets, and blood
glucose monitors for individuals with diabetes de-
scribed in section 1861(n).
‘‘(2) 
Diabetes 
outpatient 
self-management
training services (as defined in section 1861(qq)(1)).
‘‘(3) Pneumococcal, influenza, and hepatitis B
vaccines and administration described in section
1861(s)(10).
‘‘(4) Screening mammography (as defined in
section 1861(jj)).
‘‘(5) Screening pap smear and screening pelvic
exam (as defined in paragraphs (1) and (2) of sec-
tion 1861(nn), respectively).
‘‘(6) Bone mass measurement (as defined in
section 1861(rr)(1)).
‘‘(7) Prostate cancer screening test (as defined
in section 1861(oo)(1)).
‘‘(8) Colorectal cancer screening test (as de-
fined in section 1861(pp)(1)).
‘‘(9) Screening for glaucoma (as defined in sec-
tion 1861(uu)).
‘‘(10) Medical nutrition therapy services (as de-
fined in section 1861(vv)(1)).’’.
(b) WAIVER OF COINSURANCE.—
(1) IN GENERAL.—Section 1833(a)(1)(B) of the
Social Security Act (42 U.S.C. 1395l(a)(1)(B)) is
amended to read as follows: ‘‘(B) with respect to
preventive health items and services described in
subsection (p), the amounts paid shall be 100 per-
cent of the fee schedule or other basis of payment
under this title for the particular item or service,’’.
(2) ELIMINATION
OF
COINSURANCE
IN
OUT-
PATIENT HOSPITAL SETTINGS.—The third sentence
of section 1866(a)(2)(A) of the Social Security Act
(42 U.S.C. 1395cc(a)(2)(A)), as amended by section
201(c)(3), is amended by inserting after ‘‘section
1861(ww)’’ the following: ‘‘and preventive health
items and services described in section 1833(p)’’.
(c) WAIVER OF APPLICATION OF DEDUCTIBLE.—
Section 1833(b)(1) of the Social Security Act (42 U.S.C.
1395l(b)(1)) is amended to read as follows: ‘‘(1) such de-
ductible shall not apply with respect to preventive health
items and services described in subsection (p),’’.
(d) ADDING ‘‘LANCET’’ TO DEFINITION OF DME.—
Section 1861(n) of the Social Security Act (42 U.S.C.
1395x(n)) is amended by striking ‘‘blood-testing strips
and blood glucose monitors’’ and inserting ‘‘blood-testing
strips, lancets, and blood glucose monitors’’.
(e) CONFORMING AMENDMENTS.—
(1) ELIMINATION OF COINSURANCE FOR CLIN-
ICAL DIAGNOSTIC LABORATORY TESTS.—Paragraphs
(1)(D)(i) and (2)(D)(i) of section 1833(a) of the So-
cial Security Act (42 U.S.C. 1395l(a)), as amended
by section 201(b)(1) of the Medicare, Medicaid, and
SCHIP Benefits Improvement and Protection Act of
2000 (114 Stat. 2763A–481), as enacted into law by
section 1(a)(6) of Public Law 106–554, are each
amended by inserting ‘‘or which are described in
subsection (p)’’ after ‘‘assignment-related basis’’.
(2) ELIMINATION OF COINSURANCE FOR CER-
TAIN DME.—Section 1834(a)(1)(A) of the Social Se-
curity Act (42 U.S.C. 1395m(a)(1)(A)) is amended
by inserting ‘‘(or 100 percent, in the case of such an
item described in section 1833(p))’’ after ‘‘80 per-
cent’’.
(3) ELIMINATION OF DEDUCTIBLES AND COIN-
SURANCE
FOR
COLORECTAL
CANCER
SCREENING
TESTS.—Section 1834(d) of the Social Security Act
(42 U.S.C. 1395m(d)) is amended—
(A) in paragraph (2)(C)—
(i) by striking ‘‘(C) FACILITY
PAY-
MENT
LIMIT.—’’ and all that follows
through 
‘‘Notwithstanding 
subsections’’
and inserting the following:
‘‘(C) FACILITY PAYMENT LIMIT.—Notwith-
standing subsections’’;
(ii) by striking ‘‘(I) in accordance’’
and inserting the following:
‘‘(i) in accordance’’;
(iii) by striking ‘‘(II) are performed’’
and all that follows through ‘‘payment
under’’ and inserting the following:
‘‘(ii) are performed in an ambulatory
surgical center or hospital outpatient de-
partment,
payment under’’; and
(iv) by striking clause (ii); and
(B) in paragraph (3)(C)—
(i) by striking ‘‘(C) FACILITY
PAY-
MENT
LIMIT.—’’ and all that follows
through 
‘‘Notwithstanding 
subsections’’
and inserting the following:
‘‘(C) FACILITY PAYMENT LIMIT.—Notwith-
standing subsections’’; and
(ii) by striking clause (ii).
(f) EFFECTIVE DATE.—The amendments made by
this section shall apply to services furnished on or after
the day that is 1 year after the date of enactment of this
Act.
SEC. 210. PROGRAM INTEGRITY.
The Secretary, in consultation with the Inspector
General of the Department of Health and Human Serv-
ices, shall integrate supplemental preventive health serv-
ices (as defined in section 1861(ww) of the Social Security
Act (as added by the preceding provisions of this title))
with existing program integrity measures.
SEC. 211. PROMOTION OF PREVENTIVE HEALTH BENEFITS.
In order to promote the use by medicare beneficiaries
of preventive health benefits, including preventive health
services (as defined in section 1861(ww) of the Social Se-
curity Act (as added by the preceding provisions of this
title)) and preventive health items and services described
in section 1833(p) of such Act (as added by section 209),
the Secretary shall do the following:
(1) MEDICARE HANDBOOK AND OTHER ANNUAL
NOTICES.—Include in any medicare handbook and
any other annual notice provided to medicare bene-
ficiaries a detailed description of—
(A) the preventive health benefits that are
covered under the medicare program; and
(B) the importance of using such benefits.
(2) FISCAL INTERMEDIARIES AND CARRIERS.—
Require that fiscal intermediaries with a contract
under section 1816 of the Social Security Act (42
U.S.C. 1395h) and carriers with a contract under
section 1842 of such Act (42 U.S.C. 1395u) include
preventive health benefits messages on Medicare
Summary Notice Statements and Explanations of
Medicare Benefits distributed by such entities.
(3) MEDICARE PART B STATEMENT.—Regularly
include preventive health benefits messages on the
medicare part B statement.
(4) MEDICARE+CHOICE PLANS.—Require that
Medicare+Choice 
organizations 
offering 
a
Medicare+Choice 
plan 
disclose 
under 
section
1852(c)(1)(B) of the Social Security Act (42 U.S.C.
1395w–22(c)(1)(B)) information regarding the pre-
ventive health benefits that are covered under the
plan.
(5) OTHER ACTIVITIES.—Conduct activities in
addition to those described in paragraphs (1)
through (4) that the Secretary determines to be use-
ful in disseminating information to medicare bene-
ficiaries regarding—
(A) the preventive health benefits that are
covered under the medicare program;
(B) the importance of using such benefits;
and
(C) general health promotion.
TITLE 
III—NATIONAL 
FALLS
PREVENTION 
EDUCATION
AND AWARENESS CAMPAIGN
SEC. 301. NATIONAL FALLS PREVENTION EDUCATION AND
AWARENESS CAMPAIGN.
(a) IN GENERAL.—The Director of the Centers for
Disease Control and Prevention, in consultation with the
Administrator of the Health Care Financing Administra-
tion, shall conduct a national falls prevention and aware-
ness campaign to reduce fall-related injuries among medi-
care beneficiaries.
(b) REPORT TO CONGRESS.—
(1) IN GENERAL.—The Director of the Centers
for Disease Control and Prevention, in consultation
with the Administrator of the Health Care Financ-
ing Administration, shall submit to Congress a re-
port on the campaign conducted under this section.
(2) DEADLINE FOR REPORT.—The report re-
quired under paragraph (1) shall be submitted not
later than the earlier of—
(A) 6 months after the campaign is com-
pleted; or
(B) 3 years after the campaign is imple-
mented.
(3) CONTENTS
OF
REPORT.—The report re-
quired under paragraph (1) shall include the fol-
lowing:
(A) A description of the campaign.
(B) An evaluation of—
(i) whether the campaign has effec-
tively reached its target population; and
(ii) the cost-effectiveness of the cam-
paign.
(C) An assessment of whether the cam-
paign has been effective, as measured by
whether—
(i) the target population has adopted
the interventions suggested in the cam-
paign, and if not, the reasons why such
interventions have not been adopted; and
(ii) the fall rates among the target
population have decreased since the cam-
paign was implemented, and if not, the
reasons why such fall rates have not de-
creased.
(D) Any other information regarding the
campaign that the Director of the Centers for
Disease Control and Prevention determines to
be appropriate.
(c) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated such sums as may be
necessary for the purpose of carrying out this section.
TITLE 
IV—CLINICAL 
DEPRES-
SION 
SCREENING 
DEM-
ONSTRATION PROJECTS
SEC. 401. CLINICAL DEPRESSION SCREENING DEMONSTRA-
TION PROJECTS.
(a) DEFINITIONS.—In this section:
(1) DEMONSTRATION
PROJECT.—The term
‘‘demonstration project’’ means a demonstration
project established under subsection (b)(1).
(2) ELIGIBLE BENEFICIARY.—The term ‘‘eligi-
ble beneficiary’’ means an individual enrolled for
benefits under part B who is not enrolled in any of
the following:
(A) A Medicare+Choice plan under part C
of title XVIII of the Social Security Act (42
U.S.C. 1395w–21 et seq.).
(B) A plan offered by an eligible organiza-
tion under section 1876 of such Act (42 U.S.C.
1395mm).
(C) A program of all-inclusive care for the
elderly (PACE) under section 1894 of such Act
(42 U.S.C. 1395eee).
(D) A social health maintenance organiza-
tion (SHMO) demonstration project established
under section 4018(b) of the Omnibus Budget
Reconciliation Act of 1987 (Public Law 100–
203).
(E) A health care prepayment plan under
section 1833(a)(1)(A) of the Social Security Act
(42 U.S.C. 1395l(a)(1)(A)).
(3) PART B.—The term ‘‘part B’’ means part
B of the original medicare fee-for-service program
under title XVIII of the Social Security Act (42
U.S.C. 1395j et seq.).
(4) QUALIFIED HEALTH PROFESSIONAL.—The
term ‘‘qualified health professional’’ means an indi-
vidual that—
(A) is—
(i) a physician (as defined in section
1861(r)(1) of the Social Security Act (42
U.S.C. 1395x(r)(1)));
(ii) a nurse practitioner (as defined in
section 1861(aa)(5) of such Act (42 U.S.C.
1395x(aa)(5))); or
(iii) a mental health care professional
(including a clinical social worker, as de-
fined in section 1861(hh) of such Act (42
U.S.C. 1395x(hh))) that is licensed to per-
form mental health services by the State in
which a screening for clinical depression is
furnished under a demonstration project;
and
(B) has an agreement in effect with the
Secretary under which the professional agrees
to accept the amount determined by the Sec-
retary under subsection (b)(4) as full payment
for such screening and to accept an assignment
described in section 1842(b)(3)(B)(ii) of the So-
cial 
Security 
Act 
(42 
U.S.C.
1395u(b)(3)(B)(ii)) with respect to payment for
each screening furnished by the professional to
an eligible beneficiary participating in a dem-
onstration project.
(5) SCREENING FOR CLINICAL DEPRESSION.—
(A) IN
GENERAL.—The term ‘‘screening
for clinical depression’’ means a consultation
during which—
(i) a self-administered written screen-
ing test (or an alternative format for such
test pursuant to subsection (b)(3)(B)) is
made available to an eligible beneficiary;
and
(ii) a qualified health professional—
(I) interprets the results of such
test;
(II) discusses the beneficiary’s
responses to the questions on the test
with the beneficiary;
(III) assesses the beneficiary’s
risk of clinical depression; and
(IV) if the qualified health pro-
fessional determines that the bene-
ficiary is at high risk for clinical de-
pression, refers the eligible beneficiary
for a full diagnostic evaluation and
such additional treatment as may be
required.
(B) CONSTRUCTION.—Nothing in subpara-
graph (A)(ii)(IV) shall be construed as prohib-
iting a qualified health professional performing
the screening for clinical depression with re-
spect to an individual from directly providing
the diagnostic evaluation and additional treat-
ment described in such subparagraph to such
individual if legally authorized under State law
to do so.
(6) SELF-ADMINISTERED WRITTEN SCREENING
TEST.—The term ‘‘self-administered written screen-
ing test’’ means an instrument on which an eligible
beneficiary writes answers to questions designed to
enable a qualified health professional to establish the
level of risk of such eligible beneficiary for clinical
depression.
(b) DEMONSTRATION PROJECTS.—
(1) IN GENERAL.—The Secretary shall establish
and conduct demonstration projects for the purpose
of evaluating the efficacy of providing screenings for
clinical depression as a benefit under part B to eligi-
ble beneficiaries through qualified health profes-
sionals in accordance with the requirements of this
section.
(2) NUMBER, PROJECT AREAS, DURATION.—
(A) NUMBER.—The Secretary shall estab-
lish no fewer than 6 and no more than 10 dem-
onstration projects.
(B) PROJECT AREAS.—
(i) IN GENERAL.—The Secretary shall
conduct demonstration projects in geo-
graphic areas that include urban, subur-
ban, and rural areas.
(ii) SELECTION.—The Secretary shall
select the geographic areas described in
clause (i) in a manner that—
(I) ensures geographic diversity
and a mix of screening sites (includ-
ing physicians’ offices, hospital out-
patient departments, community men-
tal health centers, and skilled nursing
facilities); and
(II) gives preference to areas
with a high concentration of eligible
beneficiaries.
(C) 
DURATION.—The 
demonstration
projects under this section shall be conducted
during the 3-year period beginning on the date
on which the initial demonstration project is
implemented.
(3) IDENTIFICATION
AND
DISTRIBUTION
OF
SELF-ADMINISTERED TESTS.—
(A) IN GENERAL.—The Secretary, in con-
sultation with professionals experienced in con-
ducting 
large-scale 
depression 
screening
projects, shall—
(i) establish or identify a self-adminis-
tered written screening test to be used in
conducting the demonstration projects; and
(ii) not later than the date that is 3
months before the date on which a dem-
onstration project is implemented in a geo-
graphic area, distribute such test to each
qualified health professional that provides
services in such area in which the Sec-
retary conducts a demonstration project,
together with guidelines for making the
test available to eligible beneficiaries.
(B) ALTERNATIVE FORMATS FOR TEST.—
The Secretary shall also establish and distribute
alternative formats for the self-administered
written screening test under subparagraph (A)
which shall be available for use when cir-
cumstances do not permit an individual to com-
plete the self-administered written screening
test.
(4) PAYMENT FOR SCREENINGS FOR CLINICAL
DEPRESSION.—
(A) IN
GENERAL.—Subject to subpara-
graph (C), the Secretary shall provide for pay-
ment of the reasonable charges for each screen-
ing for clinical depression furnished to an eligi-
ble beneficiary by a qualified health professional
from the amounts transferred under subsection
(d).
(B) 
WAIVER
OF
COINSURANCE
AND
DEDUCTIBLES.—The Secretary may not require
the payment of any deductible or coinsurance
by any eligible beneficiary for a screening for
clinical depression furnished under a dem-
onstration project.
(C) FREQUENCY
LIMITATION.—No pay-
ment may be made under this section for a
screening for clinical depression if such a
screening is performed with respect to an eligi-
ble beneficiary within the year after a previous
screening of such beneficiary.
(5) WAIVER AUTHORITY.—The Secretary may
waive such requirements under title XVIII of the So-
cial Security Act (42 U.S.C. 1395 et seq.) as the
Secretary determines necessary to carry out the
demonstration projects under this section.
(c) REPORTS TO CONGRESS.—
(1) INTERIM REPORT.—
(A) IN GENERAL.—Not later than 2 years
after the Secretary implements the initial dem-
onstration project, the Secretary shall submit to
Congress a report regarding the demonstration
projects conducted under this section.
(B) CONTENTS OF REPORT.—The report
submitted 
under 
subparagraph 
(A) 
shall
contain—
(i) a description of the demonstration
projects conducted under this section;
(ii) an evaluation of—
(I) whether screening for clinical
depression is a cost-effective benefit or
a cost-saving benefit; and
(II) the level of satisfaction of el-
igible beneficiaries to whom such a
screening is furnished under the dem-
onstration project; and
(iii) any other information regarding
the demonstration projects that the Sec-
retary determines to be appropriate.
(2) FINAL
REPORT.—Not later than 1 year
after the conclusion of the demonstration projects,
the Secretary shall submit a final report to Congress
on the demonstration projects containing the rec-
ommendations of the Secretary regarding whether to
conduct the demonstration projects on a permanent
basis, together with such recommendations for legis-
lation and administrative action as the Secretary
considers appropriate.
(d) FUNDING.—The Secretary shall provide for the
transfer from the Federal Hospital Insurance Trust Fund
under section 1817 of the Social Security Act (42 U.S.C.
1395i) an amount not to exceed $30,000,000 for the costs
of carrying out the demonstration projects under this sec-
tion.
TITLE 
V—MEDICARE 
HEALTH
EDUCATION 
AND 
RISK 
AP-
PRAISAL PROGRAM
SEC. 501. MEDICARE HEALTH EDUCATION AND RISK AP-
PRAISAL PROGRAM.
Title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.) is amended by adding at the end the fol-
lowing new section:
‘‘MEDICARE HEALTH EDUCATION AND RISK APPRAISAL
PROGRAM
‘‘SEC. 1897. (a) ESTABLISHMENT.—Not later than
18 months after the date of the conclusion of the dem-
onstration projects conducted under subsection (b)(1), the
Secretary shall implement the demonstration project that
the Secretary identifies as being the most effective project
under subsection (c)(2)(C) on a nationwide and perma-
nent basis.
‘‘(b) DEMONSTRATION PROJECTS.—
‘‘(1) ESTABLISHMENT.—Not later than 1 year
after the date of enactment of this Act, the Sec-
retary, in consultation with the Health Care Financ-
ing Administration, the Centers for Disease Control
and Prevention, and the Agency for Healthcare Re-
search and Quality, shall conduct a demonstration
project for the purpose of developing a comprehen-
sive and systematic model for delivering health pro-
motion and disease prevention services that—
‘‘(A) through self-assessment identifies—
‘‘(i) behavioral risk factors, such as
tobacco use, physical inactivity, alcohol
use, and depression, among target individ-
uals;
‘‘(ii) needed medicare clinical preven-
tive and screening health benefits among
target individuals; and
‘‘(iii) functional and self-management
information the Secretary determines to be
appropriate;
‘‘(B) provides ongoing followup to reduce
risk factors and promote the appropriate use of
preventive and screening health benefits;
‘‘(C) improves clinical outcomes, satisfac-
tion, quality of life, and appropriate use by tar-
get individuals of items and services covered
under the medicare program; and
‘‘(D) provides target individuals with infor-
mation regarding the adoption of healthy behav-
iors.
‘‘(2) SELF-ASSESSMENT AND PROVISION OF IN-
FORMATION.—The Secretary shall conduct the dem-
onstration projects established under paragraph (1)
in the following manner:
‘‘(A) SELF-ASSESSMENT.—
‘‘(i) IN
GENERAL.—The Secretary
shall test different—
‘‘(I) methods of making self-as-
sessments available to each target in-
dividual;
‘‘(II) methods of encouraging
each target individual to participate in
the self-assessment; and
‘‘(III) methods for processing re-
sponses to the self-assessment.
‘‘(ii) CONTENTS.—A self-assessment
made available under clause (i) shall
include—
‘‘(I) questions regarding behav-
ioral risk factors;
‘‘(II) questions regarding needed
preventive screening health services;
‘‘(III) questions regarding the
target individual’s preferences for re-
ceiving follow-up information; and
‘‘(IV) other information that the
Secretary determines appropriate.
‘‘(B) PROVISION OF INFORMATION.—After
each target individual completes the self-assess-
ment, the Secretary shall ensure that the target
individual is provided with such information as
the Secretary determines appropriate, which
may include—
‘‘(i) information regarding the results
of the self-assessment;
‘‘(ii) recommendations regarding any
appropriate behavior modification based on
the self-assessment;
‘‘(iii) information regarding how to
access behavior modification assistance
that promotes healthy behavior, including
information on nurse hotlines, counseling
services, provider services, and case-man-
agement services;
‘‘(iv) information, feedback, support,
and recommendations regarding any need
for clinical preventive and screening health
services or treatment; and
‘‘(v) referrals to available community
resources in order to assist the target indi-
vidual in reducing health risks.
‘‘(3) PROJECT AREAS AND DURATION.—
‘‘(A) PROJECT
AREAS.—The Secretary
shall implement the demonstration projects in
geographic areas that include urban, suburban,
and rural areas.
‘‘(B) DURATION.—The Secretary shall
conduct the demonstration projects during the
3-year period beginning on the date on which
the first demonstration project is implemented.
‘‘(c) REPORT TO CONGRESS.—
‘‘(1) IN GENERAL.—Not later than 1 year after
the date on which the demonstration projects con-
clude, the Secretary shall submit to Congress a re-
port on such projects.
‘‘(2) CONTENTS OF REPORT.—The report sub-
mitted under paragraph (1) shall—
‘‘(A) describe the demonstration projects
conducted under this section;
‘‘(B) identify the demonstration project
that is the most effective; and
‘‘(C) contain such other information re-
garding the demonstration projects as the Sec-
retary determines appropriate.
‘‘(3) MEASUREMENT OF EFFECTIVENESS.—For
purposes of paragraph (2)(B), in identifying the
demonstration project that is the most effective, the
Secretary shall consider—
‘‘(A) how successful the project was at—
‘‘(i) reaching target individuals and
engaging them in an assessment of the risk
factors of such individuals;
‘‘(ii) educating target individuals on
healthy behaviors and getting such individ-
uals to modify their behaviors in order to
diminish the risk of chronic disease; and
‘‘(iii) ensuring that target individuals
were provided with necessary information;
‘‘(B) the cost-effectiveness of the dem-
onstration project; and
‘‘(C) the degree of beneficiary satisfaction
under the demonstration projects.
‘‘(d) WAIVER
AUTHORITY.—The Secretary may
waive such requirements under this title as the Secretary
determines necessary to carry out the demonstration
projects under this section.
‘‘(e) FUNDING.—There are authorized to be appro-
priated $25,000,000 for carrying out the demonstration
project under this section.
‘‘(f) DEFINITIONS.—In this section:
‘‘(1) TARGET INDIVIDUAL.—The term ‘target
individual’ means each individual that is—
‘‘(A) entitled to benefits under part A or
enrolled under part B, including an individual
enrolled under the Medicare+Choice program
under part C; or
‘‘(B) between the ages of 50 and 64 who
is not a beneficiary under this title.
‘‘(2) MAJOR BEHAVIORAL RISK FACTOR.—The
term ‘major behavioral risk factor’ includes—
‘‘(A) the lack of proper nutrition;
‘‘(B) the use of alcohol;
‘‘(C) the lack of regular exercise;
‘‘(D) the use of tobacco;
‘‘(E) depression; and
‘‘(F) any other risk factor identified by the
Secretary.’’.
TITLE 
VI—STUDIES, 
EVALUA-
TIONS, AND REPORTS IN THE
FIELD OF DISEASE PREVEN-
TION AND THE ELDERLY
SEC. 601. MEDPAC EVALUATION AND REPORT ON MEDI-
CARE BENEFIT PACKAGE IN RELATION TO
PRIVATE SECTOR BENEFIT PACKAGES.
(a) IN GENERAL.—Section 1805(b) of the Social Se-
curity Act (42 U.S.C. 1395b–6(b)), as amended by section
544(b) of the Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000 (114 Stat.
2763A–551), as enacted into law by section 1(a)(6) of
Public Law 106–554, is amended—
(1) in paragraph (1)—
(A) in subparagraph (C), by striking
‘‘and’’ at the end;
(B) in subparagraph (D), by striking the
period and inserting ‘‘; and’’; and
(C) by adding at the end the following new
subparagraph:
‘‘(E) on the date that is 3 years after the
date of enactment of the Medicare Wellness Act
of 2001, and each successive 3-year anniversary
thereafter, submit the report described in para-
graph (8)(C) to Congress.’’; and
(2) by adding at the end the following new
paragraph:
‘‘(8) EVALUATION
OF
MEDICARE
BENEFIT
PACKAGE IN RELATION TO PRIVATE SECTOR BEN-
EFIT PACKAGES.—
‘‘(A) EVALUATION.—The Commission shall
evaluate—
‘‘(i) the benefit package offered under
the medicare program under this title; and
‘‘(ii) the degree to which such benefit
package compares to the benefit packages
offered by health benefit programs avail-
able in the private sector to individuals
over age 55.
‘‘(B) ISSUES.—In conducting the evalua-
tion under subparagraph (A)(ii), the Commis-
sion shall address the following issues:
‘‘(i) Whether the benefit packages
available under the programs are—
‘‘(I) similar;
‘‘(II) appropriate for the enroll-
ees of the programs (based on what
experts recommend for such enroll-
ees);
‘‘(III) actuarially equivalent; and
‘‘(IV) comprehensive.
‘‘(ii) The financial liabilities of enroll-
ees of the programs and whether such li-
abilities are appropriate.
‘‘(iii) The ability of enrollees of the
programs to take advantage of benefits
under the programs.
‘‘(C) REPORT.—The Commission shall
submit a report to Congress that shall
contain—
‘‘(i) a detailed statement of the find-
ings and conclusions of the Commission re-
garding the evaluation conducted under
subparagraph (A);
‘‘(ii) the recommendations of the
Commission regarding changes in the ben-
efit package offered under the medicare
program under this title that would keep
the program modern and competitive in re-
lation to health benefit packages offered by
health benefit programs available in the
private sector to individuals over age 55;
and
‘‘(iii) the recommendations of the
Commission for such legislation and ad-
ministrative actions as it considers appro-
priate.’’.
(b) EFFECTIVE DATE.—The amendments made by
this section shall take effect on the date of enactment of
this Act.
SEC. 602. NATIONAL INSTITUTE ON AGING STUDY AND RE-
PORT ON WAYS TO IMPROVE THE QUALITY
OF LIFE OF ELDERLY.
(a) STUDIES.—The Director of the National Institute
on Aging, in consultation with the Working Group on Dis-
ease Self-Management and Health Promotion (established
in section 102) and the United States Preventive Services
Task Force, shall conduct 1 or more studies focusing on
ways to—
(1) improve quality of life for the elderly; and
(2) develop better ways to prevent or delay the
onset of age-related functional decline and disease
and disability among the elderly.
(b) REPORTS.—
(1) REPORT FOR EACH STUDY.—The Director
of the National Institute on Aging, in consultation
with the Working Group on Disease Self-Manage-
ment and Health Promotion and the United States
Preventive Services Task Force, shall submit a re-
port to the Secretary regarding each study con-
ducted under subsection (a), together with a detailed
statement of research findings and conclusions that
are scientifically valid and are demonstrated to pre-
vent or delay the onset of chronic illness or disability
among the elderly.
(2) TIMING FOR SUBMITTING REPORTS.—Each
report regarding a study that is required to be sub-
mitted pursuant to paragraph (1) shall be submitted
by not later than the earlier of—
(A) the date that is 18 months after the
completion of the study involved; or
(B) January 1, 2008.
(c) TRANSMISSION TO INSTITUTE OF MEDICINE.—
Upon receipt of each report described in subsection (b),
the Secretary shall transmit such report to the Institute
of Medicine of the National Academy of Sciences for con-
sideration in its effort to conduct the comprehensive study
of current literature and best practices in the field of
health promotion and disease prevention among the medi-
care beneficiaries described in section 603.
(d) AUTHORIZATION OF APPROPRIATIONS.—
(1) IN GENERAL.—There are authorized to be
appropriated for the purpose of carrying out this
section such sums as may be necessary for the pe-
riod of fiscal years 2002 through 2008.
(2) AVAILABILITY.—Any sums appropriated
under the authorization contained in this subsection
shall remain available, without fiscal year limitation,
until September 30, 2008.
SEC. 603. INSTITUTE OF MEDICINE MEDICARE PREVEN-
TION BENEFIT STUDY AND REPORT.
(a) STUDY.—
(1) IN GENERAL.—The Secretary shall contract
with the Institute of Medicine of the National Acad-
emy of Sciences to—
(A) conduct a comprehensive study of cur-
rent literature and best practices in the field of
health promotion and disease prevention among
medicare beneficiaries, including the issues de-
scribed in paragraph (2); and
(B) submit the report described in sub-
section (b).
(2) ISSUES
STUDIED.—The study required
under paragraph (1) shall include an assessment
of—
(A) whether each health promotion and
disease prevention benefit covered under the
medicare program is—
(i) medically effective (as defined in
section 101(4)); and
(ii) a cost-effective benefit (as defined
in section 101(2)) or a cost-saving benefit
(as defined in section 101(3));
(B) utilization by medicare beneficiaries of
such benefits (including any barriers to or in-
centives to increase utilization);
(C) quality of life issues associated with
such benefits; and
(D) health promotion and disease preven-
tion benefits that are not covered under the
medicare program that would affect all medi-
care beneficiaries.
(b) REPORTS.—
(1) THREE-YEAR REPORT.—On the date that is
3 years after the date of enactment of this Act, and
each successive 3-year anniversary thereafter, the
Institute of Medicine of the National Academy of
Sciences shall submit to the President a report that
contains—
(A) a detailed statement of the findings
and conclusions of the study conducted under
subsection (a); and
(B) the recommendations for legislation
described in paragraph (3).
(2) INTERIM REPORT BASED ON NEW GUIDE-
LINES.—If the United States Preventive Services
Task Force or the Task Force on Community Pre-
ventive Services establishes new guidelines regarding
preventive health benefits for medicare beneficiaries
more than 1 year prior to the date that a report de-
scribed in paragraph (1) is due to be submitted to
the President, then not later than 6 months after
the date such new guidelines are established, the In-
stitute of Medicine of the National Academy of
Sciences shall submit to the President a report that
contains a detailed description of such new guide-
lines. Such report may also contain recommenda-
tions for legislation described in paragraph (3).
(3) RECOMMENDATIONS
FOR
LEGISLATION.—
The Institute of Medicine of the National Academy
of Sciences, in consultation with the United States
Preventive Services Task Force and the Task Force
on Community Preventive Services, shall develop
recommendations in legislative form that—
(A) prioritize the preventive health benefits
under the medicare program; and
(B) modify such benefits, including adding
new benefits under such program, based on the
study conducted under subsection (a).
(c) TRANSMISSION TO CONGRESS.—
(1) IN GENERAL.—On the day on which the re-
port described in paragraph (1) of subsection (b) (or
paragraph (2) of such subsection if the report con-
tains recommendations in legislative form described
in subsection (b)(3)) is submitted to the President,
the President shall transmit the report and rec-
ommendations to Congress.
(2) DELIVERY.—Copies of the report and rec-
ommendations in legislative form required to be
transmitted to Congress under paragraph (1) shall
be delivered—
(A) to both Houses of Congress on the
same day;
(B) to the Clerk of the House of Rep-
resentatives if the House is not in session; and
(C) to the Secretary of the Senate if the
Senate is not in session.
SEC. 604. FAST-TRACK CONSIDERATION OF PREVENTION
BENEFIT LEGISLATION.
(a) RULES OF HOUSE OF REPRESENTATIVES AND
SENATE.—This section is enacted by Congress—
(1) as an exercise of the rulemaking power of
the House of Representatives and the Senate, re-
spectively, and is deemed a part of the rules of each
House of Congress, but—
(A) is applicable only with respect to the
procedure to be followed in that House of Con-
gress in the case of an implementing bill (as de-
fined in subsection (d)); and
(B) supersedes other rules only to the ex-
tent that such rules are inconsistent with this
section; and
(2) with full recognition of the constitutional
right of either House of Congress to change the
rules (so far as relating to the procedure of that
House of Congress) at any time, in the same man-
ner and to the same extent as in the case of any
other rule of that House of Congress.
(b) INTRODUCTION AND REFERRAL.—
(1) INTRODUCTION.—
(A) IN GENERAL.—Subject to paragraph
(2), on the day on which the President trans-
mits the report pursuant to section 603(c) to
the House of Representatives and the Senate,
the recommendations in legislative form trans-
mitted by the President with respect to such re-
port shall be introduced as a bill (by request)
in the following manner:
(i) HOUSE OF REPRESENTATIVES.—In
the House of Representatives, by the Ma-
jority Leader, for himself and the Minority
Leader, or by Members of the House of
Representatives designated by the Majority
Leader and Minority Leader.
(ii) SENATE.—In the Senate, by the
Majority Leader, for himself and the Mi-
nority Leader, or by Members of the Sen-
ate designated by the Majority Leader and
Minority Leader.
(B) SPECIAL
RULE.—If either House of
Congress is not in session on the day on which
such recommendations in legislative form are
transmitted, the recommendations in legislative
form shall be introduced as a bill in that House
of Congress, as provided in subparagraph (A),
on the first day thereafter on which that House
of Congress is in session.
(2) REFERRAL.—Such bills shall be referred by
the presiding officers of the respective Houses to the
appropriate committee, or, in the case of a bill con-
taining provisions within the jurisdiction of 2 or
more committees, jointly to such committees for con-
sideration of those provisions within their respective
jurisdictions.
(c) CONSIDERATION.—After the recommendations in
legislative form have been introduced as a bill and referred
under subsection (b), such implementing bill shall be con-
sidered in the same manner as an implementing bill is con-
sidered under subsections (d), (e), (f), and (g) of section
151 of the Trade Act of 1974 (19 U.S.C. 2191).
(d) IMPLEMENTING BILL DEFINED.—In this section,
the term ‘‘implementing bill’’ means only the recommenda-
tions in legislative form of the Institute of Medicine of the
National Academy of Sciences described in section
603(b)(3), transmitted by the President to the House of
Representatives and the Senate under subsection 603(c),
and introduced and referred as provided in subsection (b)
as a bill of either House of Congress.
(e) COUNTING OF DAYS.—For purposes of this sec-
tion, any period of days referred to in section 151 of the
Trade Act of 1974 shall be computed by excluding—
(1) the days on which either House of Congress
is not in session because of an adjournment of more
than 3 days to a day certain or an adjournment of
Congress sine die; and
(2) any Saturday and Sunday, not excluded
under paragraph (1), when either House is not in
session.
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