instruction:
In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
question:
-S-E-C-T-I-O-N -1-. -A-C-Q-U-I-S-I-T-I-O-N -O-F -R-O-O-S-E-V-E-L-T 
              -F-A-M-I-L-Y -L-A-N-D-S-.

    -(-a-) -I-n -G-e-n-e-r-a-l-.---
            -(-1-) -G-e-n-e-r-a-l -a-u-t-h-o-r-i-t-y-.----T-h-e 
        -S-e-c-r-e-t-a-r-y -o-f -t-h-e -I-n-t-e-r-i-o-r 
        -(-h-e-r-e-i-n-a-f-t-e-r -r-e-f-e-r-r-e-d -t-o -a-s -t-h-e 
        -`-`-S-e-c-r-e-t-a-r-y-'-'-) -m-a-y -a-c-q-u-i-r-e-, -b-y 
        -p-u-r-c-h-a-s-e -w-i-t-h -d-o-n-a-t-e-d -o-r 
        -a-p-p-r-o-p-r-i-a-t-e-d -f-u-n-d-s-, -d-o-n-a-t-i-o-n-, -o-r 
        -o-t-h-e-r-w-i-s-e-, -l-a-n-d-s -a-n-d -i-n-t-e-r-e-s-t-s -i-n 
        -l-a-n-d -(-i-n-c-l-u-d-i-n-g -d-e-v-e-l-o-p-m-e-n-t 
        -r-i-g-h-t-s -a-n-d -e-a-s-e-m-e-n-t-s-) -i-n -t-h-e 
        -p-r-o-p-e-r-t-i-e-s -l-o-c-a-t-e-d -a-t -H-y-d-e -P-a-r-k-, 
        -N-e-w -Y-o-r-k-, -t-h-a-t -w-e-r-e -o-w-n-e-d -b-y 
        -F-r-a-n-k-l-i-n -D-. -R-o-o-s-e-v-e-l-t -o-r -h-i-s 
        -f-a-m-i-l-y -a-t -t-h-e -t-i-m-e -o-f -h-i-s -d-e-a-t-h-, -a-s 
        -d-e-p-i-c-t-e-d -o-n -t-h-e -m-a-p -e-n-t-i-t-l-e-d 
        -`-`-R-o-o-s-e-v-e-l-t -F-a-m-i-l-y -E-s-t-a-t-e-'-' -a-n-d 
        -d-a-t-e-d -N-o-v-e-m-b-e-r -1-9-, -1-9-9-3-.
            -(-2-) -L-i-m-i-t-a-t-i-o-n-s-.---
                    -(-A-) -R-e-s-i-d-e-n-t-i-a-l -p-r-o-p-e-r-t-y-.---
                -T-h-e -S-e-c-r-e-t-a-r-y -m-a-y -o-n-l-y 
                -a-c-q-u-i-r-e -t-h-o-s-e -r-e-s-i-d-e-n-t-i-a-l 
                -p-r-o-p-e-r-t-i-e-s -o-n -t-h-e -l-a-n-d-s -a-n-d 
                -i-n-t-e-r-e-s-t-s -i-n -l-a-n-d -d-e-p-i-c-t-e-d -o-n 
                -t-h-e -m-a-p -r-e-f-e-r-r-e-d -t-o -i-n 
                -s-u-b-s-e-c-t-i-o-n -(-a-) -t-h-a-t -w-e-r-e 
                -o-w-n-e-d -o-r -o-c-c-u-p-i-e-d -b-y -F-r-a-n-k-l-i-n 
                -D-. -R-o-o-s-e-v-e-l-t -o-r -h-i-s -f-a-m-i-l-y-, 
                -i-n-c-l-u-d-i-n-g -h-i-s -p-a-r-e-n-t-s-, 
                -s-i-b-l-i-n-g-s-, -w-i-f-e-, -a-n-d -c-h-i-l-d-r-e-n-.
                    -(-B-) -S-t-a-t-e -l-a-n-d-s-.----L-a-n-d-s -a-n-d 
                -i-n-t-e-r-e-s-t-s -i-n -l-a-n-d -d-e-p-i-c-t-e-d -o-n 
                -t-h-e -m-a-p -r-e-f-e-r-r-e-d -t-o -i-n 
                -s-u-b-s-e-c-t-i-o-n -(-a-) -t-h-a-t -a-r-e -o-w-n-e-d 
                -b-y -t-h-e -S-t-a-t-e -o-f -N-e-w -Y-o-r-k-, -o-r -a 
                -p-o-l-i-t-i-c-a-l -s-u-b-d-i-v-i-s-i-o-n -o-f -t-h-e 
                -S-t-a-t-e-, -m-a-y -o-n-l-y -b-e -a-c-q-u-i-r-e-d -b-y 
                -d-o-n-a-t-i-o-n-.
            -(-3-) -P-r-i-o-r-i-t-y-.----I-n -a-c-q-u-i-r-i-n-g 
        -l-a-n-d-s -a-n-d -i-n-t-e-r-e-s-t-s -i-n -l-a-n-d 
        -p-u-r-s-u-a-n-t -t-o -t-h-i-s -s-e-c-t-i-o-n-, -t-h-e 
        -S-e-c-r-e-t-a-r-y -s-h-a-l-l-, -t-o -t-h-e -e-x-t-e-n-t 
        -p-o-s-s-i-b-l-e-, -g-i-v-e -p-r-i-o-r-i-t-y -t-o 
        -a-c-q-u-i-r-i-n-g -t-h-e -t-r-a-c-t -o-f -l-a-n-d-s 
        -c-o-m-m-o-n-l-y -k-n-o-w-n -a-s -t-h-e -`-`-O-p-e-n -P-a-r-k 
        -H-o-d-h-o-m-e -T-r-a-c-t-'-'-, -a-s -g-e-n-e-r-a-l-l-y 
        -d-e-p-i-c-t-e-d -o-n -t-h-e -m-a-p -r-e-f-e-r-r-e-d -t-o -i-n 
        -s-u-b-s-e-c-t-i-o-n -(-a-)-.
            -(-4-) -C-o-s-t-s-.----T-h-e -S-e-c-r-e-t-a-r-y -m-a-y 
        -p-a-y -t-h-e -c-o-s-t-s-, -i-n-c-l-u-d-i-n-g -t-i-t-l-e 
        -s-e-a-r-c-h -a-n-d -s-u-r-v-e-y-, -a-s-s-o-c-i-a-t-e-d 
        -w-i-t-h -t-h-e -a-c-q-u-i-s-i-t-i-o-n -o-f -l-a-n-d-s -a-n-d 
        -i-n-t-e-r-e-s-t-s -i-n -l-a-n-d -p-u-r-s-u-a-n-t -t-o -t-h-i-s 
        -s-e-c-t-i-o-n-.
    -(-b-) -A-d-m-i-n-i-s-t-r-a-t-i-o-n-.----L-a-n-d-s -a-n-d 
-i-n-t-e-r-e-s-t-s -i-n -l-a-n-d -a-c-q-u-i-r-e-d -b-y -t-h-e 
-S-e-c-r-e-t-a-r-y -p-u-r-s-u-a-n-t -t-o -t-h-i-s -s-e-c-t-i-o-n 
-s-h-a-l-l -b-e -a-d-d-e-d -t-o-, -a-n-d -a-d-m-i-n-i-s-t-e-r-e-d -a-s 
-p-a-r-t -o-f-, -t-h-e -F-r-a-n-k-l-i-n -D-e-l-a-n-o -R-o-o-s-e-v-e-l-t 
-N-a-t-i-o-n-a-l -H-i-s-t-o-r-i-c -S-i-t-e -o-r -t-h-e -E-l-e-a-n-o-r 
-R-o-o-s-e-v-e-l-t -N-a-t-i-o-n-a-l -H-i-s-t-o-r-i-c -S-i-t-e-, -a-s 
-a-p-p-r-o-p-r-i-a-t-e-.
    -(-c-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f 
-A-p-p-r-o-p-r-i-a-t-i-o-n-s-.----T-h-e-r-e -a-r-e -a-u-t-h-o-r-i-z-e-d 
-t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d -s-u-c-h -s-u-m-s -a-s -a-r-e 
-n-e-c-e-s-s-a-r-y -t-o -c-a-r-r-y -o-u-t -t-h-i-s -A-c-t-.

SECTION 1. ACQUISITION OF LANDS.

    (a) In General.--(1) The Secretary of the Interior (hereinafter 
referred to as the ``Secretary'') is authorized to acquire, by purchase 
with donated or appropriated funds, donation, or otherwise, lands and 
interests therein in the following properties located at Hyde Park, New 
York identified as lands critical for protection as depicted on the map 
entitled ``Roosevelt Family Estate'' and dated September 1994:
            (A) The ``Open Park Hodhome Tract'', consisting of 
        approximately 30 acres, which shall be the highest priority for 
        acquisition.
            (B) The ``Top Cottage Tract'', consisting of approximately 
        30 acres.
            (C) The ``Poughkeepsie Shopping Center, Inc. Tract'', 
        consisting of approximately 55 acres.
    (b) Administration.--Lands and interests therein acquired by the 
Secretary pursuant to this Act shall be added to, and administered by 
the Secretary as part of the Franklin Delano Roosevelt National 
Historic Site or the Eleanor Roosevelt National Historic Site, as 
appropriate.
    (c) Authorization of Appropriations.--There are hereby authorized 
to be appropriated not to exceed $3,000,000 to carry out this Act.
answer:
Authorizes the Secretary of the Interior to acquire lands and interests in specified properties located at Hyde Park, New York, identified as lands critical for protection on the Roosevelt Family Estate to be added to and administered by the Secretary as part of the Franklin Delano Roosevelt National Historic Site or the Eleanor Roosevelt National Historic Site. Authorizes appropriations.


question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``American Workforce Improvement and 
Jobs Protection Act''.

SEC. 2. EXEMPTING ALIENS EARNING MASTER'S OR HIGHER DEGREE IN UNITED 
              STATES FROM NUMERICAL LIMITATIONS ON H-1B NONIMMIGRANTS.

    Section 214(g) of the Immigration and Nationality Act (8 U.S.C. 
1184(g)) is amended by adding at the end the following:
    ``(9) For any fiscal year, the applicable numerical limitation 
contained in paragraph (1)(A) shall not apply to any nonimmigrant alien 
issued a visa or otherwise provided status under section 
101(a)(15)(H)(i)(b) who has earned a master's or higher degree from an 
institution of higher education (as defined in section 101(a) of the 
Higher Education Act of 1965 (20 U.S.C. 1001(a))), until the number of 
aliens who are exempted from such numerical limitation during such year 
exceeds 20,000.''.

SEC. 3. MAKING PERMANENT CERTAIN REQUIREMENTS AND AUTHORITIES WITH 
              RESPECT TO H-1B NONIMMIGRANTS.

    (a) Attestation Requirements.--Section 212(n)(1)(E)(ii) of the 
Immigration and Nationality Act (8 U.S.C. 1182(n)(1)(E)(ii)) is amended 
by striking ``subparagraph, and before October 1, 2003,'' and inserting 
``subparagraph''.
    (b) Fee.--Section 214(c)(9)(A) of the Immigration and Nationality 
Act (8 U.S.C. 1184(c)(9)(A)) is amended by striking ``before October 1, 
2003''.
    (c) Department of Labor Investigative Authorities.--Section 
413(e)(2) of the American Competitiveness and Workforce Improvement Act 
of 1998 (8 U.S.C. 1182 note) is repealed.
    (d) Effective Dates.--
            (1) Attestation requirements.--The amendment made by 
        subsection (a) shall apply to applications under section 
        212(n)(1) of the Immigration and Nationality Act filed on or 
        after the date that is 30 days after the date of the enactment 
        of this Act.
            (2) Fee.--The amendment made by subsection (b) shall apply 
        to petitions under section 214(c) of the Immigration and 
        Nationality Act filed on or after the date that is 30 days 
        after the date of the enactment of this Act.
            (3) Department of labor investigative authority.--The 
        amendment made by subsection (c) shall take effect on the date 
        of the enactment of this Act.

SEC. 4. FRAUD PREVENTION AND DETECTION FEE.

    (a) Imposition of Fee.--Section 214(c) of the Immigration and 
Nationality Act (8 U.S.C. 1184(c)) is amended by adding at the end the 
following:
    ``(12)(A) In addition to any other fees authorized by law, the 
Secretary of Homeland Security shall impose a fraud prevention and 
detection fee on an employer filing a petition under paragraph (1)--
            ``(i) initially to grant an alien nonimmigrant status 
        described in subparagraph (H)(i)(b) or (L) of section 
        101(a)(15); or
            ``(ii) to obtain authorization for an alien having such 
        status to change employers.
    ``(B) In addition to any other fees authorized by law, the 
Secretary of State shall impose a fraud prevention and detection fee on 
an alien filing an application abroad for a visa authorizing admission 
to the United States as a nonimmigrant described in section 
101(a)(15)(L), if the alien is covered under a blanket petition 
described in paragraph (2)(A).
    ``(C) The amount of the fee imposed under subparagraph (A) or (B) 
shall be $500.
    ``(D) The fee imposed under subparagraph (A) or (B) shall only 
apply to principal aliens and not to the spouses or children who are 
accompanying or following to join such principal aliens.
    ``(E) Fees collected under this paragraph shall be deposited in the 
Treasury in accordance with section 286(v).''.
    (b) Establishment of Account; Use of Fees.--Section 286 of the 
Immigration and Nationality Act (8 U.S.C. 1356) is amended by adding at 
the end the following:
    ``(v) H-1B and L Fraud Prevention and Detection Account.--
            ``(1) In general.--There is established in the general fund 
        of the Treasury a separate account, which shall be known as the 
        `H-1B and L Fraud Prevention and Detection Account'. 
        Notwithstanding any other provision of law, there shall be 
        deposited as offsetting receipts into the account all fees 
        collected under section 214(c)(12).
            ``(2) Use of fees to combat fraud.--
                    ``(A) Secretary of state.--One-third of the amounts 
                deposited into the H-1B and L Fraud Prevention and 
                Detection Account shall remain available to the 
                Secretary of State until expended for programs and 
                activities at United States embassies and consulates 
                abroad--
                            ``(i) to increase the number diplomatic 
                        security personnel assigned exclusively to the 
                        function of preventing and detecting fraud by 
                        applicants for visas described in subparagraph 
                        (H)(i) or (L) of section 101(a)(15);
                            ``(ii) otherwise to prevent and detect such 
                        fraud pursuant to the terms of a memorandum of 
                        understanding or other cooperative agreement 
                        between the Secretary of State and the 
                        Secretary of Homeland Security; and
                            ``(iii) upon request by the Secretary of 
                        Homeland Security, to assist such Secretary in 
                        carrying out the fraud prevention and detection 
                        programs and activities described in 
                        subparagraph (B).
                    ``(B) Secretary of homeland security.--One-third of 
                the amounts deposited into the H-1B and L Fraud 
                Prevention and Detection Account shall remain available 
                to the Secretary of Homeland Security until expended 
                for programs and activities to prevent and detect fraud 
                with respect to petitions under paragraph (1) or (2)(A) 
                of section 214(c) to grant an alien nonimmigrant status 
                described in subparagraph (H)(i) or (L) of section 
                101(a)(15).
                    ``(C) Secretary of labor.--One-third of the amounts 
                deposited into the H-1B and L Fraud Prevention and 
                Detection Account shall remain available to the 
                Secretary of Labor until expended for enforcement 
                programs and activities described in section 212(n).
                    ``(D) Consultation.--The Secretary of State, the 
                Secretary of Homeland Security, and the Secretary of 
                Labor shall consult one another with respect to the use 
                of the funds in the H-1B and L Fraud Prevention and 
                Detection Account.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date of the enactment of this Act, and the fees imposed 
under such amendments shall apply to petitions under section 214(c) of 
the Immigration and Nationality Act, and applications for nonimmigrant 
visas under section 222 of such Act, filed on or after the date that is 
90 days after the date of the enactment of this Act.

SEC. 5. ENSURING INTEGRITY OF VISAS FOR INTRACOMPANY TRANSFEREES.

    (a) Nonimmigrant L-1 Visa Category.--
            (1) In general.--Section 214(c)(2) of the Immigration and 
        Nationality Act (8 U.S.C. 1184(c)(2)) is amended by adding at 
        the end the following:
    ``(F) An alien who will serve in a capacity involving specialized 
knowledge with respect to an employer for purposes of section 
101(a)(15)(L) and will be stationed primarily at the worksite of an 
employer other than the petitioning employer or its affiliate, 
subsidiary, or parent shall not be eligible for classification under 
section 101(a)(15)(L) if--
            ``(i) the alien will be controlled and supervised 
        principally by such unaffiliated employer; or
            ``(ii) the placement of the alien at the worksite of the 
        unaffiliated employer is part of an arrangement merely to 
        provide labor for the unaffiliated employer rather than in 
        connection with the provision of a product or service for which 
        specialized knowledge specific to the petitioning employer is 
        necessary.''.
            (2) Applicability.--The amendment made by paragraph (1) 
        shall apply to petitions filed on or after the effective date 
        of this section, whether for initial, extended, or amended 
        classification.
    (b) Requirement for Prior Continuous Employment for Certain 
Intracompany Transferees.--
            (1) In general.--Section 214(c)(2)(A) of the Immigration 
        and Nationality Act (8 U.S.C. 1184(c)(2)(A)) is amended by 
        striking the last sentence (relating to reduction of the 1-year 
        period of continuous employment abroad to 6 months).
            (2) Applicability.--The amendment made by paragraph (1) 
        shall apply only to petitions for initial classification filed 
        on or after the effective date of this section.
    (c) Maintenance of Statistics.--
            (1) In general.--The Secretary of Homeland Security shall 
        maintain statistics regarding petitions filed, approved, 
        extended, and amended with respect to nonimmigrants described 
        in section 101(a)(15)(L) of the Immigration and Nationality Act 
        (8 U.S.C. 1101(a)(15)(L)), including the number of such 
        nonimmigrants who are classified on the basis of specialized 
        knowledge and the number of nonimmigrants who are classified on 
        the basis of specialized knowledge in order to work primarily 
        at offsite locations.
            (2) Applicability.--Paragraph (1) shall apply to petitions 
        filed on or after the effective date of this section.
    (d) Effective Date.--This section and the amendments made by this 
section shall take effect 180 days after the date of the enactment of 
this Act.
answer:
American Workforce Improvement and Jobs Protection Act - Amends the Immigration and Nationality Act to exempt up to 20,000 aliens holding a master's or higher degree from the numerical limitation on H-1B (temporary employment in a specialty occupation) nonimmigrants in any fiscal year.

Makes permanent: (1) the attestation requirement concerning nondisplacement of U.S. workers applicable to H-1B-dependent employers and willful violators; (2) the filing fee applicable to H-1B petitioners; and (3) the Secretary of Labor's authority under the American Competitiveness and Workforce Improvement Act to investigate an employer's alleged failure to meet specified labor attestation conditions (by repealing a sunset provision in that Act).

Requires the Secretary of Homeland Security to impose a fraud prevention and detection fee on H-1B or L (intracompany business personnel) petitioners for use in combating fraud and carrying out labor attestation enforcement activities. Establishes an H-1B and L Fraud Prevention and Detection Account for the deposit of such fees.

Renders ineligible for L visa status those aliens who will serve in a capacity involving specialized knowledge at the worksite of an employer other than the petitioning employer or its affiliate if: (1) the alien will be controlled principally by the unaffiliated employer; or (2) the placement with the unaffiliated employer is part of an arrangement merely to provide labor rather than to use the alien's specialized knowledge.

Eliminates the current reduction in the continuous employment requirement for aliens seeking L visa status pursuant to an employer's blanket petition.

Requires the Secretary of Homeland Security to maintain statistics regarding L visa petitions.


question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Diabetes Self-Management Training 
Act of 2003''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Diabetes is the fifth leading cause of death in the 
        United States. Over 17,000,000 Americans (6.2 percent of the 
        population) currently are living with diabetes, a number that 
        is estimated to increase to 29,000,000 by the year 2050. In 
        2002, diabetes accounted for $132,000,000,000 in direct and 
        indirect health care costs. Diabetes is widely recognized as 
        one of the top public health threats facing our nation today.
            (2) Diabetes can occur in 2 forms--type 1 diabetes is 
        caused by the body's inability to produce insulin, a hormone 
        that allows glucose or sugar to enter and fuel cells, and type 
        2 diabetes, which occurs when the body fails to make enough 
        insulin, or fails to properly use it. People with type 1 
        diabetes are required to take daily insulin injections to stay 
        alive. While some people with type 2 diabetes need insulin 
        shots, others with type 2 diabetes can control their diabetes 
        through healthy diet, nutrition, and lifestyle changes. Type 2 
        diabetes accounts for up to 95 percent of all diabetes cases 
        affecting 8 percent of the population age 20 and older. The 
        prevalence of type 2 diabetes has tripled in the last 30 years, 
        with much of that increase due to an upsurge in obesity.
            (3) The Diabetes Prevention Program study in 2002 found 
        that participants (all of whom were at increased risk of 
        developing type 2 diabetes) who made lifestyle changes reduced 
        their risk of getting type 2 diabetes by 58 percent.
            (4) Diabetes self-management training (DSMT) also called 
        diabetes education, provides knowledge and skill training to 
        patients with diabetes, helping them identify barriers, 
        facilitate problem solving, and develop coping skills to 
        effectively manage their diabetes. Unlike many other diseases, 
        diabetes requires constant vigilance on the part of the patient 
        and demands far more than just taking pills or insulin shots. A 
        certified diabetes educator is a health care professional--
        often a nurse, dietitian, or pharmacist, who specializes in 
        helping people with diabetes develop the self-management skills 
        needed to stay healthy and avoid costly acute complications and 
        emergency care, as well as debilitating secondary conditions 
        caused by diabetes.
            (5) There are currently over 13,000 diabetes educators in 
        the United States, most of whom are certified diabetes 
        educators (CDEs). To earn a CDE designation, a health care 
        professional must be licensed or have received a masters degree 
        in a relevant public health concentration, have completed 2 
        years of professional practice experience in diabetes self-
        management training, and have provided a minimum of 1000 hours 
        of diabetes self-management training. Many other health care 
        professionals that are able to bill for diabetes education 
        through the medicare program have far less experience or 
        ability to provide the skilled expertise to help people with 
        diabetes self-manage the disease. CDEs are the best trained 
        health care professionals to provide DSMT and their experience 
        and background is in stark contrast to the 12 hours of 
        continuing education that non-physician health care providers 
        or suppliers must obtain every 2 years, as required by the 
        Centers for Medicare & Medicaid Services.
            (6) CDEs represent the only group of health care 
        professionals who provide diabetes self-management training 
        that have not been recognized as health care providers and are 
        therefore precluded from directly billing the medicare program 
        for DSMT. Adding CDEs as providers to that program would give 
        diabetes patients access to the care they need.

SEC. 3. RECOGNITION OF CERTIFIED DIABETES EDUCATORS AS MEDICARE 
              PROVIDERS FOR PURPOSES OF DIABETES OUTPATIENT SELF-
              MANAGEMENT TRAINING SERVICES.

    (a) In General.--Section 1861(qq) of the Social Security Act (42 
U.S.C. 1395x(qq)) is amended--
            (1) in paragraph (2)--
                    (A) in subparagraph (A), by inserting ``and 
                includes a certified diabetes educator (as defined in 
                paragraph (3)) who is recognized by the National 
                Certification Board of Diabetes Educators and is 
                working within a recognized diabetes education 
                program'' before the semicolon at the end; and
                    (B) in subparagraph (B), by inserting before the 
                period at the end the following: ``or is a certified 
                diabetes educator (as so defined) who is recognized by 
                the National Certification Board of Diabetes Educators 
                and is working within a recognized diabetes education 
                program''; and
            (2) by adding at the end the following:
    ``(3) For purposes of paragraph (2), the term `certified diabetes 
educator' means an individual who--
            ``(A) is a health care professional who specializes in 
        helping individuals with diabetes develop the self-management 
        skills needed to overcome the daily challenges and problems 
        caused by the disease;
            ``(B) is a licensed nurse, occupational therapist, 
        optometrist, pharmacist, physical therapist, physician 
        assistant, podiatrist, a registered dietitian, or has an 
        advanced degree in nutrition, social work, clinical psychology, 
        exercise physiology, health education or a related public 
        health area such as health education, health promotion, health 
        and social behavior or health communication;
            ``(C) has at least 2 years of professional practice 
        experience in diabetes self-management training;
            ``(D) has provided a minimum of 1000 hours of diabetes 
        self-management training to patients within the most recent 5 
        years; and
            ``(E) has passed a certification exam approved by the 
        National Certification Board of Diabetes Educators.''.
    (b) GAO Study and Report.--
            (1) Study.--The Comptroller General of the United States 
        shall conduct a study to determine the barriers, if any, that 
        exist in rural areas to successfully becoming a recognized 
        diabetes education program, including the difficulty of rural 
        health care professionals in becoming certified diabetes 
        educators (as defined in section 1861(qq)(3) of the Social 
        Security Act (as added by subsection (a)(2))), and whether 
        individuals with diabetes who live in rural areas have barriers 
        to accessing diabetes self-management training.
            (2) Report.--Not later than 1 year after the date of 
        enactment of this Act, the Comptroller General of the United 
        States shall submit a report to Congress regarding the study 
        conducted under paragraph (2).
    (c) Effective Date.--The amendments made by subsection (a) apply to 
diabetes outpatient self-management training services furnished on or 
after October 1, 2003.
answer:

Diabetes Self-Management Training Act of 2003 - Amends title XVIII (Medicare) of the Social Security Act to provide for the recognition of certified diabetes educators as Medicare providers for purposes of diabetes outpatient self-management training services.

Directs the Comptroller General to study and report to Congress on: (1) the barriers, if any, that exist in rural areas to successfully becoming a recognized diabetes education program, including the difficulty of rural heath care professionals in becoming certified diabetes educators; and (2) whether individuals with diabetes who live in rural areas have barriers to accessing diabetes self-management training.