Definition: In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
Input: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Medicare Diabetes Prevention Act of
2013''.

SEC. 2. DIABETES PREVENTION UNDER THE MEDICARE PROGRAM.

(a) Coverage of Diabetes Prevention Program Services.--
(1) Coverage of services.--
(A) In general.--Section 1861(s)(2) of the Social
Security Act (42 U.S.C. 1395x(s)(2)) is amended--
(i) in subparagraph (EE), by striking
''and'' after the semicolon at the end;
(ii) in subparagraph (FF), by inserting
''and'' after the semicolon at the end; and
(iii) by adding at the end the following
new subparagraph:
''(GG) items and services furnished under a diabetes
prevention program (as defined in subsection (iii)(1)) to an
eligible diabetes prevention program individual (as defined in
subsection (iii)(2));''.
(B) Definitions.--Section 1861 of the Social
Security Act (42 U.S.C. 1395x) is amended by adding at
the end the following new subsection:

''Diabetes Prevention Program; Eligible Diabetes Prevention Program
Individual; Qualified Diabetes Prevention Program Provider

''(iii)(1)(A) The term 'diabetes prevention program' means a
program that--
''(i) meets the criteria described in subparagraph (B); and
''(ii) is furnished by a qualified diabetes prevention
program provider (as defined in paragraph (3)(A)).
''(B) The Secretary shall establish the criteria for a diabetes
prevention program. Such criteria shall be in accordance with the
standards under the National Diabetes Prevention Program, as
established by the Centers for Disease Control and Prevention, and
shall require that the program 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. In establishing such
criteria, the Secretary may also consider other factors or clinical
evidence as the Secretary determines appropriate.
''(C) Items and services furnished under a diabetes prevention
program may be furnished in a community setting, as defined by the
Secretary.
''(D) The Secretary shall establish procedures under which a
qualified diabetes prevention program provider may contract with a
diabetes prevention program delivery partner to furnish the items and
services under a diabetes prevention program. For purposes of this
subsection, the term 'diabetes prevention program delivery partner'
means an entity, including non-profit organizations, public and private
hospitals, State and local departments of public health, and Federally
qualified health centers, that meets criteria established by the
Secretary. Such criteria shall be in accordance with the standards
under the National Diabetes Prevention Program, as established by the
Centers for Disease Control and Prevention. In establishing such
criteria, the Secretary may also consider other factors or clinical
evidence as the Secretary determines appropriate.
''(2)(A) The term 'eligible diabetes prevention program individual'
means an individual at risk for diabetes (as defined in subsection
(yy)(2)) who would benefit from items and services under a diabetes
prevention program, as determined based on criteria established by the
Secretary.
''(B) The criteria established under subparagraph (A) shall be in
accordance with the standards under the National Diabetes Prevention
Program, as established by the Centers for Disease Control and
Prevention. In establishing such criteria, the Secretary may also
consider other factors or clinical evidence as the Secretary determines
appropriate.
''(3)(A)(i) The term 'qualified diabetes prevention program
provider' means any entity, including a Federally qualified health
center, that the Secretary determines--
''(I) is appropriate to furnish items and services under a
diabetes prevention program; and
''(II) meets criteria established by the Secretary, in
consultation with the Centers for Disease Control and
Prevention.
''(ii) A qualified diabetes prevention program provider may be, as
determined appropriate by the Secretary, a supplier (as defined in
subsection (d)), a provider of services (as defined in subsection (u)),
a health insurance or services company, a community-based organization,
or any other appropriate entity.
''(B) A qualified diabetes prevention program provider shall--
''(i) furnish the items and services under the diabetes
prevention program through a delivery partner (pursuant to
paragraph (1)(D)) unless no such delivery partner is available;
''(ii) manage and track the outcomes of a diabetes
prevention program (including attendance and weight loss of
participating individuals) through defined systems, including
outcomes of programs furnished under contract with a diabetes
prevention program delivery partner as defined in paragraph
(1)(D);
''(iii) implement business processes to manage program
workflow, such as eligibility, reporting, claims billing, class
scheduling, and enrollment;
''(iv) manage and verify billing accuracy and beneficiary
eligibility (as described in paragraph (2));
''(v) comply with applicable laws and regulations and
ensure such compliance by a diabetes prevention program
delivery partner;
''(vi) perform various forms of engagement with, and
outreach to, eligible diabetes prevention program individuals,
including those participating in programs furnished under
contract with a diabetes prevention program delivery partner;
''(vii) comply with all program integrity requirements as
established by the Secretary; and
''(viii) perform such other functions as established by the
Secretary.''.
(2) Amount of payment.--Section 1833(a)(1) of the Social
Security Act (42 U.S.C. 1395l(a)(1)) is amended--
(A) by striking ''and (Z)'' and inserting ''(Z)'';
and
(B) by inserting before the semicolon at the end
the following: '', and (AA) with respect to items and
services furnished under a diabetes prevention program
(as defined in section 1861(iii)(1)), the amount paid
shall be 100 percent of (i) except as provided in
clause (ii), the lesser of the actual charge for the
items and services or the amount determined under the
fee schedule that applies to such items and services
under this part, as determined by the Secretary, and
(ii) in the case of such items and services that are
covered OPD services (as defined in subsection
(t)(1)(B)), the amount determined under subsection
(t)''.
(3) Waiver of application 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 ''(10)''; and
(B) by inserting before the period the following:
'', and (11) such deductible shall not apply with
respect to items and services under a diabetes
prevention program (as defined in section
1861(iii)(1))''.
(4) Assignment of claims.--Section 1842(b)(18)(C) of the
Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by
adding at the end the following new clause:
''(vii) A qualified diabetes prevention program provider
(as defined in section 1861(iii)(3)(A)).''.
(5) Exclusion of items and services under a diabetes
prevention program from skilled nursing facility prospective
payment system.--Section 1888(e)(2)(A)(ii) of the Social
Security Act (42 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by
inserting ''items and services under a diabetes prevention
program (as defined in section 1861(iii)(1)),'' after
''qualified psychologist services,''.
(6) Inclusion in federally qualified health center
services.--Section 1861(aa)(3) of the Social Security Act (42
U.S.C. 1395x(aa)(3)) is amended--
(A) in subparagraph (A), by striking ''and'' at the
end;
(B) in subparagraph (B), by striking the comma at
the end and inserting ''; and''; and
(C) by adding after subparagraph (B) the following
new subparagraph:
''(C) items and services under a diabetes prevention
program (as defined in section 1861(iii)(1)),''.
(7) Special consideration for the dual eligible
population.--In implementing the amendments made by this
subsection, the Secretary of Health and Human Services shall
give special consideration to the needs of individuals who are
dually eligible for benefits under the Medicare and Medicaid
programs.
(8) Evaluation and report to congress.--
(A) Evaluation.--The Secretary of Health and Human
Services shall conduct an evaluation on the coverage of
items and services under a diabetes prevention program
under the Medicare program, as added by the amendments
made by this subsection. Such evaluation shall include
an analysis of--
(i) the impact of the provision of such
coverage on Medicare beneficiaries, including
the impact on various populations, such as
individuals who are dually eligible for
benefits under the Medicare and Medicaid
programs, and the impact of the provision of
such coverage on health disparities;
(ii) the rate at which physicians refer
eligible diabetes prevention program
individuals to diabetes prevention programs
under the Medicare program;
(iii) Medicare beneficiary participation
levels in diabetes prevention programs under
the Medicare program and the awareness of
Medicare beneficiaries of the benefit;
(iv) the health outcomes resulting from
completion of a diabetes prevention program
under the Medicare program;
(v) program integrity protections important
to diabetes prevention programs under the
Medicare program; and
(vi) other areas determined appropriate by
the Secretary.
(B) Report.--Not later than January 1, 2019, the
Secretary of Health and Human Services shall submit to
Congress a report on the evaluation conducted under
subparagraph (A), together with recommendations for
such legislation and administrative actions as the
Secretary determines appropriate.
(9) Effective date.--The amendments made by paragraphs (1)
through (6) shall apply with respect to services furnished on
or after January 1, 2015.
(b) Inclusion of Referral Rates to Diabetes Prevention Programs in
the Medicare Physician Quality Reporting System.--Section
1848(k)(2)(C)(i) of the Social Security Act (42 U.S.C. 1395w-
4(k)(2)(C)(i)) is amended by adding at the end the following new
sentence: ''For purposes of reporting data on quality measures for
covered professional services furnished during 2018 and each subsequent
year, the quality measures specified under this paragraph shall include
a measure with respect to referrals of eligible diabetes prevention
program individuals (as defined in paragraph (2) of section 1861(iii))
to diabetes prevention programs (as defined in paragraph (1) of such
section).''.
(c) Inclusion of Diabetes Risk Assessment in Medicare Personalized
Prevention Plan.--
(1) In general.--Section 1861(hhh)(2)(C) of the Social
Security Act (42 U.S.C. 1395x(hhh)(2)(C)) is amended by
inserting before the period at the end the following: '', and
an assessment of whether the individual is an individual at
risk for diabetes (as defined in subsection (yy)(2))''.
(2) Effective date.--The amendments made by this subsection
shall apply to personalized prevention plans created or updated
on or after January 1, 2015.

SEC. 3. FINDINGS; SENSE OF THE SENATE REGARDING DIABETES PREVENTION
UNDER THE MEDICAID PROGRAM.

(a) Findings.--Congress makes the following findings:
(1) The prevalence and cost of diabetes is a significant
concern for State Medicaid programs. By 2021, the Medicaid
program is expected to cover 13,000,000 people with diabetes
and about 9,000,000 people who may have pre-diabetes. By 2021,
States will spend an estimated $83,000,000,000 on individuals
with diabetes or pre-diabetes.
(2) The National Diabetes Prevention Program, as
established by the Centers for Disease Control and Prevention,
has been proven to reduce the onset of diabetes in at-risk
adults by 58 percent, using a cost-effective, community-based
intervention.
(b) Sense of the Senate.--It is the sense of the Senate that the
National Diabetes Prevention Program presents an opportunity for States
to reduce the incidence of diabetes among individuals enrolled in their
Medicaid programs.
Output:
Medicare Diabetes Prevention Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to provide coverage of diabetes prevention program services to an eligible diabetes prevention program individual. Directs the Secretary of Health and Human Services (HHS) to establish the criteria for a diabetes prevention program in accordance with the standards under the National Diabetes Prevention Program established by the Centers for Disease Control and Prevention (CDC). Excludes items and services under a diabetes prevention program from the skilled nursing facility prospective payment system. Includes: (1) items and services under a diabetes prevention programs among federally qualified health center services, (2) rates of referrals of eligible individuals to diabetes prevention programs among the quality measures for covered professional services in the Medicare physician quality reporting system, and (3) an individual's diabetes risk assessment in the individual's Medicare personalized prevention plan. Expresses the sense of the House that the National Diabetes Prevention Program presents an opportunity for states to reduce the incidence of diabetes among individuals enrolled in their Medicaid programs.