Title: Treat and Reduce Obesity Act of 2017
Policy area: Health

Summary:
Treat and Reduce Obesity Act of 2017
This bill allows coverage, under Medicare, of intensive behavioral therapy for obesity furnished by providers other than primary care physicians and practitioners.
Additionally, it allows coverage under Medicare's prescription drug benefit of drugs used for the treatment of obesity or for weight loss management for individuals who are overweight.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 830 Introduced in Senate (IS)]

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115th CONGRESS
  1st Session
                                 S. 830

  To amend title XVIII of the Social Security Act to provide for the 
 coordination of programs to prevent and treat obesity, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                April 5 (legislative day, April 4), 2017

  Mr. Cassidy (for himself, Mr. Carper, Mr. Grassley, Mr. Coons, Ms. 
  Murkowski, Mr. Heinrich, and Mrs. Capito) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to provide for the 
 coordination of programs to prevent and treat obesity, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Treat and Reduce Obesity Act of 
2017''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) According to the Centers for Disease Control, about 34 
        percent of adults aged 65 and over were obese in the period of 
        2009 through 2012, representing almost 15 million people.
            (2) Obesity increases the risk for chronic diseases and 
        conditions, including high blood pressure, heart disease, 
        certain cancers, arthritis, mental illness, lipid disorders, 
        sleep apnea, and type 2 diabetes.
            (3) More than half of Medicare beneficiaries are treated 
        for 5 or more chronic conditions per year. The rate of obesity 
        among Medicare patients doubled from 1987 to 2002, and Medicare 
        spending on obese individuals during that time more than 
        doubled.
            (4) Men and women with obesity at age 65 have decreased 
        life expectancy of 1.6 years for men and 1.4 years for women.
            (5) The direct and indirect cost of obesity is more than 
        $450 billion annually.
            (6) On average, a Medicare beneficiary with obesity costs 
        $1,964 more than a normal-weight beneficiary.
            (7) The prevalence of obesity among older individuals in 
        the United States is growing at a linear rate and, if nothing 
        changes, nearly half of the elderly population of the United 
        States will have obesity in 2030 according to a Congressional 
        Research Report on obesity.

SEC. 3. AUTHORITY TO EXPAND HEALTH CARE PROVIDERS QUALIFIED TO FURNISH 
              INTENSIVE BEHAVIORAL THERAPY.

    Section 1861(ddd) of the Social Security Act (42 U.S.C. 1395x(ddd)) 
is amended by adding at the end the following new paragraph:
            ``(4)(A) Subject to subparagraph (B), the Secretary may, in 
        addition to qualified primary care physicians and other primary 
        care practitioners, cover intensive behavioral therapy for 
        obesity furnished by any of the following:
                    ``(i) A physician (as defined in subsection (r)(1)) 
                who is not a qualified primary care physician.
                    ``(ii) Any other appropriate health care provider 
                (including a physician assistant, nurse practitioner, 
                or clinical nurse specialist (as those terms are 
                defined in subsection (aa)(5)), a clinical 
                psychologist, a registered dietitian or nutrition 
                professional (as defined in subsection (vv))).
                    ``(iii) An evidence-based, community-based 
                lifestyle counseling program approved by the Secretary.
            ``(B) In the case of intensive behavioral therapy for 
        obesity furnished by a provider described in clause (ii) or 
        (iii) of subparagraph (A), the Secretary may only cover such 
        therapy if such therapy is furnished--
                    ``(i) upon referral from, and in coordination with, 
                a physician or primary care practitioner operating in a 
                primary care setting or any other setting specified by 
                the Secretary; and
                    ``(ii) in an office setting, a hospital out-patient 
                department, a community-based site that complies with 
                the Federal regulations concerning the privacy of 
                individually identifiable health information 
                promulgated under section 264(c) of the Health 
                Insurance Portability and Accountability Act of 1996, 
                or another setting specified by the Secretary.
            ``(C) In order to ensure a collaborative effort, the 
        coordination described in subparagraph (B)(i) shall include the 
        health care provider or lifestyle counseling program 
        communicating to the referring physician or primary care 
        practitioner any recommendations or treatment plans made 
        regarding the therapy.''.

SEC. 4. MEDICARE PART D COVERAGE OF OBESITY MEDICATION.

    (a) In General.--Section 1860D-2(e)(2)(A) of the Social Security 
Act (42 U.S.C. 1395w-102(e)(2)(A)) is amended, in the first sentence--
            (1) by striking ``and other than'' and inserting ``other 
        than''; and
            (2) by inserting after ``benzodiazepines),'' the following: 
        ``and other than subparagraph (A) of such section if the drug 
        is used for the treatment of obesity (as defined in section 
        1861(yy)(2)(C)) or for weight loss management for an individual 
        who is overweight (as defined in section 1861(yy)(2)(F)(i)) and 
        has one or more related comorbidities,''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to plan years beginning on or after the date that is 2 years 
after the date of the enactment of this Act.

SEC. 5. REPORT TO CONGRESS.

    Not later than the date that is 1 year after the date of the 
enactment of this Act, and every 2 years thereafter, the Secretary of 
Health and Human Services shall submit a report to Congress describing 
the steps the Secretary has taken to implement the provisions of, and 
amendments made by, this Act. Such report shall also include 
recommendations for better coordination and leveraging of programs 
within the Department of Health and Human Services and other Federal 
agencies that relate in any way to supporting appropriate research and 
clinical care (such as any interactions between physicians and other 
health care providers and their patients) to treat, reduce, and prevent 
obesity in the adult population.
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