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Question: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Facilitating Access to Speedy
Transmissions for Networks, E-commerce and Telecommunications (FASTNET)
Act''.

SEC. 2. FINDINGS AND PURPOSE.

(a) Findings.--Congress finds the following:
(1) The Telecommunications Act of 1996 was enacted to
foster the rapid deployment of advanced telecommunications and
information technologies and services to all Americans by
promoting competition and reducing regulation in
telecommunications markets nationwide.
(2) The Telecommunications Act of 1966 specifically
recognized the unique abilities and circumstances of local
exchange carriers with fewer than two percent of the Nation's
subscriber lines installed in the aggregate nationwide.
(3) Given the markets two percent carriers typically serve,
such carriers are uniquely positioned to accelerate the
deployment of advanced services and competitive initiatives for
the benefit of consumers in less densely populated regions of
the Nation.
(4) Existing regulations are typically tailored to the
circumstances of larger carriers and therefore often impose
disproportionate burdens on two percent carriers, impeding such
carriers' deployment of advanced telecommunications services
and competitive initiatives to consumers in less densely
populated regions of the Nation.
(5) Reducing regulatory burdens on two percent carriers
will enable such carriers to devote additional resources to the
deployment of advanced services and to competitive initiatives
to benefit consumers in less densely populated regions of the
Nation.
(6) Reducing regulatory burdens on two percent carriers
will increase such carriers' ability to respond to marketplace
conditions, allowing them to accelerate deployment of advanced
services and competitive initiatives to benefit consumers in
less densely populated regions of the Nation.
(b) Purposes.--The purposes of this Act are--
(1) to accelerate the deployment of advanced services and
the development of competition in the telecommunications
industry for the benefit of consumers in all regions of the
Nation, consistent with the Telecommunications Act of 1996, by
reducing regulatory burdens on local exchange carriers with
fewer than two percent of the Nation's subscriber lines
installed in the aggregate nationwide;
(2) to improve such carriers' flexibility to undertake such
initiatives; and
(3) to allow such carriers to redirect resources from
paying the costs of such regulatory burdens to increasing
investment in such initiatives.

SEC. 3. DEFINITION.

Section 3 of the Communications Act of 1934 (47 U.S.C. 153) is
amended--
(1) by redesignating paragraphs (51) and (52) as paragraphs
(52) and (53), respectively; and
(2) by inserting after paragraph (50) the following:
''(51) Two percent carrier.--The term 'two percent carrier'
means an incumbent local exchange carrier within the meaning of
section 251(h) whose access lines, when aggregated with the
access lines of any local exchange carrier that such incumbent
local exchange carrier directly or indirectly controls, is
controlled by, or is under common control with, are fewer than
two percent of the Nation's subscriber lines installed in the
aggregate nationwide.''.

SEC. 4. REGULATORY RELIEF FOR TWO PERCENT CARRIERS.

Title II of the Communications Act of 1934 is amended by adding at
the end thereof a new part IV as follows:

''PART IV--PROVISIONS CONCERNING TWO PERCENT CARRIERS

''SEC. 281. REDUCED REGULATORY REQUIREMENTS FOR TWO PERCENT CARRIERS.

''(a) Commission To Take Into Account Differences.--In adopting
rules that apply to incumbent local exchange carriers (within the
meaning of section 251(h)), the Commission shall separately evaluate
the burden that any proposed regulatory, compliance, or reporting
requirements would have on two percent carriers.
''(b) Effect of Commission's Failure To Take Into Account
Differences.--If the Commission adopts a rule that applies to incumbent
local exchange carriers and fails to separately evaluate the burden
that any proposed regulatory, compliance, or reporting requirement
would have on two percent carriers, the Commission shall not enforce
the rule against two percent carriers unless and until the Commission
performs such separate evaluation.
''(c) Additional Review Not Required.--Nothing in this section
shall be construed to require the Commission to conduct a separate
evaluation under subsection (a) if the rules adopted do not apply to
two percent carriers, or such carriers are exempted from such rules.
''(d) Savings Clause.--Nothing in this section shall be construed
to prohibit any size-based differentiation among carriers mandated by
this Act, chapter 6 of title 5, United State Code, the Commission's
rules, or any other provision of law.
''(e) Effective Date.--The provisions of this section shall apply
with respect to any rule adopted on or after the date of enactment of
this section.

''SEC. 282. LIMITATION OF REPORTING REQUIREMENTS.

''(a) Limitation.--The Commission shall not require a two percent
carrier--
''(1) to file cost allocation manuals or to have such
manuals audited or attested, but a two percent carrier that
qualifies as a class A carrier shall annually certify to the
Commission that the two percent carrier's cost allocation
complies with the rules of the Commission; or
''(2) to file Automated Reporting and Management
Information Systems (ARMIS) reports, except for purposes of
section 224.
''(b) Preservation of Authority.--Except as provided in subsection
(a), nothing in this Act limits the authority of the Commission to
obtain access to information under sections 211, 213, 215, 218, and 220
with respect to two percent carriers.

''SEC. 283. INTEGRATED OPERATION OF TWO PERCENT CARRIERS.

''The Commission shall not require any two percent carrier to
establish or maintain a separate affiliate to provide any common
carrier or noncommon carrier services, including local and
interexchange services, commercial mobile radio services, advanced
services (within the meaning of section 706 of the Telecommunications
Act of 1996), paging, Internet, information services or other enhanced
services, or other services. The Commission shall not require any two
percent carrier and its affiliates to maintain separate officers,
directors, or other personnel, network facilities, buildings, research
and development departments, books of account, financing, marketing,
provisioning, or other operations.

''SEC. 284. PARTICIPATION IN TARIFF POOLS AND PRICE CAP REGULATION.

''(a) NECA Pool.--The participation or withdrawal from
participation by a two percent carrier of one or more study areas in
the common line tariff administered and filed by the National Exchange
Carrier Association or any successor tariff or administrator shall not
obligate such carrier to participate or withdraw from participation in
such tariff for any other study area. The Commission may require a two
percent carrier to give 60 days notice of its intent to participate or
withdraw from participation in such common line tariff with respect to
a study area. Except as permitted by section 310(f)(3), a two percent
carrier's election under this subsection shall be binding for one year
from the date of the election.
''(b) Price Cap Regulation.--A two percent carrier may elect to be
regulated by the Commission under price cap rate regulation, or elect
to withdraw from such regulation, for one or more of its study areas.
The Commission shall not require a carrier making an election under
this subsection with respect to any study area or areas to make the
same election for any other study area. Except as permitted by section
310(f)(3), a two percent carrier's election under this subsection shall
be binding for one year from the date of the election.

''SEC. 285. DEPLOYMENT OF NEW TELECOMMUNICATIONS SERVICES BY TWO
PERCENT COMPANIES.

''(a) One-Day Notice of Deployment.--The Commission shall permit
two percent carriers to introduce new interstate telecommunications
services by filing a tariff on one day's notice showing the charges,
classifications, regulations, and practices therefor, without obtaining
a waiver, or make any other showing before the Commission in advance of
the tariff filing. The Commission shall not have authority to approve
or disapprove the rate structure for such services shown in such
tariff.
''(b) Definition.--For purposes of subsection (a), the term 'new
interstate telecommunications service' means a class or subclass of
service not previously offered by the two percent carrier that enlarges
the range of service options available to ratepayers of such carrier.

''SEC. 286. ENTRY OF COMPETING CARRIER.

''(a) Pricing Flexibility.--Notwithstanding any other provision of
this Act, any two percent carrier shall be permitted to de-average its
interstate switched or special access rates, file tariffs on one day's
notice, and file contract-based tariffs for interstate switched or
special access services immediately upon certifying to the Commission
that a telecommunications carrier unaffiliated with such carrier is
engaged in facilities-based entry within such carrier's service area. A
two percent carrier subject to rate-of-return regulation with respect
to an interstate switched or special access service, for which pricing
flexibility has been exercised pursuant to this subsection, shall
compute its interstate rate of return based on the nondiscounted rate
for such service.
''(b) Streamlined Pricing Regulation.--Notwithstanding any other
provision of this Act, upon receipt by the Commission of a
certification by a two percent carrier that--
''(1) a local exchange carrier, or its affiliate, or
''(2) a local exchange carrier operated by, or owned in
whole or part by, a governmental authority,
is engaged in facilities-based entry within the two percent carrier's
service area, the Commission shall regulate the two percent carrier as
non-dominant and shall not require the tariffing of the interstate
service offerings of the two percent carrier.
''(c) Participation in Exchange Carrier Association Tariff.--A two
percent carrier that meets the requirements of subsection (a) or (b) of
this section with respect to one or more study areas shall be permitted
to participate in the common line tariff administered and filed by the
National Exchange Carrier Association or any successor tariff or
administrator, by electing to include one or more of its study areas in
such tariff.
''(d) Definitions.--For purposes of this section:
''(1) Facilities-based entry.--The term 'facilities-based
entry' means, within the service area of a two percent
carrier--
''(A) the provision or procurement of local
telephone exchange switching or its equivalent; and
''(B) the provision of telephone exchange service
to at least one unaffiliated customer.
''(2) Contract-based tariff.--The term 'contract-based
tariff' shall mean a tariff based on a service contract entered
into between a two percent carrier and one or more customers of
such carrier. Such tariff shall include--
''(A) the term of the contract, including any
renewal options;
''(B) a brief description of each of the services
provided under the contract;
''(C) minimum volume commitments for each service,
if any;
''(D) the contract price for each service or
services at the volume levels committed to by the
customer or customers;
''(E) a brief description of any volume discounts
built into the contract rate structure; and
''(F) a general description of any other
classifications, practices, and regulations affecting
the contract rate.
''(3) Service area.--The term 'service area' has the same
meaning as in section 214(e)(5).

''SEC. 287. SAVINGS PROVISIONS.

''(a) Commission Authority.--Nothing in this part shall be
construed to restrict the authority of the Commission under sections
201 through 208.
''(b) Rural Telephone Company Rights.--Nothing in this part shall
be construed to diminish the rights of rural telephone companies
otherwise accorded by this Act, or the rules, policies, procedures,
guidelines, and standards of the Commission as of the date of enactment
of this section.
''(c) State Authority.--Nothing in this part shall be construed to
limit or affect any authority (as of August 1, 2001) of the States over
charges, classifications, practices, services, facilities, or
regulations for or in connection with intrastate communications service
by wire or radio of any carrier.''.

SEC. 5. LIMITATION ON MERGER REVIEW.

(a) Amendment.--Section 310 of the Communications Act of 1934 (47
U.S.C. 310) is amended by adding at the end the following:
''(f) Deadline for Making Public Interest Determination.--
''(1) Time limit.--In connection with any merger between
two percent carriers, or the acquisition, directly or
indirectly, by a two percent carrier or its affiliate of
securities or assets of another carrier or its affiliate, if
the merged or acquiring carrier remains a two percent carrier after the
merger or acquisition, the Commission shall make any determinations
required by this section and section 214, and shall rule on any
petition for waiver of the Commission's rules or other request related
to such determinations, not later than 60 days after the date an
application with respect to such merger or acquisition is submitted to
the Commission.
''(2) Approval absent action.--If the Commission does not
approve or deny an application as described in paragraph (1) by
the end of the period specified, the application shall be
deemed approved on the day after the end of such period. Any
such application deemed approved under this subsection shall be
deemed approved without conditions.
''(3) Election permitted.--The Commission shall permit a
two percent carrier to make an election pursuant to section 284
with respect to any local exchange facilities acquired as a
result of a merger or acquisition that is subject to the review
deadline established in paragraph (1) of this subsection.''.
(b) Effective Date.--The provisions of this section shall apply
with respect to any application that is submitted to the Commission on
or after the date of enactment of this Act. Applications pending with
the Commission on the date of enactment of this Act shall be subject to
the requirements of this section as if they had been filed with the
Commission on the date of enactment of this Act.

SEC. 6. TIME LIMITS FOR ACTION ON PETITIONS FOR RECONSIDERATION OR
WAIVER.

(a) Amendment.--Section 405 of the Communications Act of 1934 (47
U.S.C. 405) is amended by adding to the end the following:
''(c) Expedited Action Required.--
''(1) Time limit.--Within 90 days after receiving from a
two percent carrier a petition for reconsideration or other
review filed under this section or a petition for waiver of a
rule, policy, or other Commission requirement, the Commission
shall issue an order granting or denying such petition. If the
Commission fails to act on a petition for waiver subject to the
requirements of this section within this 90-day period, the
relief sought in such petition shall be deemed granted. If the
Commission fails to act on a petition for reconsideration or
other review subject to the requirements of this section within
such 90-day period, the Commission's enforcement of any rule
the reconsideration or other review of which was specifically
sought by the petitioning party shall be stayed with respect to
that party until the Commission issues an order granting or
denying such petition.
''(2) Finality of action.--Any order issued under paragraph
(1), or any grant of a petition for waiver that is deemed to
occur as a result of the Commission's failure to act under
paragraph (1), shall be a final order and may be appealed.''.
(b) Effective Date.--The provisions of this section shall apply
with respect to any petition for reconsideration or other review or
petition for waiver that is submitted to the Commission on or after the
date of enactment of this Act. Petitions for reconsideration or
petitions for waiver pending with the Commission on the date of
enactment of this Act shall be subject to the requirements of this
section as if they had been filed on the date of enactment of this Act.

SEC. 7. NATIONAL SECURITY AND LAW ENFORCEMENT EXCEPTIONS.

Notwithstanding sections 310 and 405 of the Communications Act of
1934 (47 U.S.C. 310 and 405), the 60-day time period under section
310(f)(1) of that Act, as added by section 5 of this Act, and the 90-
day time period under section 405(c)(1) of that Act, as added by
section 6 of this Act, shall not apply to a petition or application
under section 310 or 405 if an Executive Branch agency with cognizance
over national security, law enforcement, or public safety matters,
including the Department of Defense, Department of Justice, and the
Federal Bureau of Investigation, submits a written filing to the
Federal Communications Commission advising the Commission that the
petition or application may present national security, law enforcement,
or public safety concerns that may not be resolved within the 60-day or
90-day time period, respectively.

Answer: Facilitating Access to Speedy Transmissions for Networks, E-commerce and Telecommunications (FASTNET) Act - Amends the Communications Act of 1934 to define a "two percent carrier" (carrier) as an incumbent local exchange carrier whose access lines, when combined with the access lines of any other carrier that such carrier controls, are fewer than two percent of the subscriber lines installed in the aggregate nationwide.Directs the Federal Communications Commission (FCC), in adopting rules that apply to such carriers, to separately evaluate the burden that any proposed regulatory, compliance, or reporting requirements would have on such carriers. Prohibits the FCC from requiring such carriers to: (1) file cost allocation manuals or Automated Reporting and Management Information Systems reports; or (2) establish or maintain a separate affiliate to provide any common carrier or noncommon carrier services.Limits carrier participation in tariff pools and price cap regulation.Requires the FCC to permit such carriers to introduce new interstate telecommunications services by filing a tariff on one day's notice.Allows such carriers to de-average its interstate switched or special access rates, file tariffs on one day's notice, and file contract-based tariffs for switched or special access services upon certifying that a telecommunications carrier unaffiliated with such carrier is engaged in facilities-based entry within such carrier's service area. Limits FCC carrier merger review authority. Provides time limits for FCC action on petitions for reconsideration or waiver of a rule, policy, or requirement.

Question: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Early Education Employee Benefit Act
of 2002''.

SEC. 2. AUTHORITY TO MAKE GRANTS.

The Secretary of Health and Human Services may make grants on a
competitive basis, and payable during a period of not less than 2 years
and not more than 5 years, to eligible States and political
subdivisions of States--
(1) to establish innovative partnerships with private
partners to reduce the cost incurred by employees and union
members to obtain early education (including child care,
preschool, and other early childhood programs), or
(2) to assist private partners to pay part of the cost of
acquiring, building, and renovating physical premises to be
used as new early education facilities.

SEC. 3. ELIGIBILITY OF STATES AND POLITICAL SUBDIVISIONS OF STATES TO
RECEIVE GRANTS.

To be eligible to receive a grant under section 2, a State or a
political subdivision of a State shall submit to the Secretary an
application at such time, in such form, and containing such information
as the Secretary may require by rule, including--
(1) the agency designated by the State, or the political
subdivision of a State, to serve as the lead agency that will
administer such grant,
(2) a description of the program such applicant intends to
carry out with such grant,
(3) a description of the source, and increasing annual
amount, of the funds such applicant will use to pay the non-
Federal share of the cost to carry out such program during a
period not less than 2 years and not more than 5 years, and
(4) an agreement that such State or such political
subdivision--
(A) will contribute (from non-Federal funds) to
carry out such program, an amount equal to 50 percent
of the amount of such grant,
(B) will not require a private partner to offer on-
site early education as a condition for participation
in an Early Education Benefit Agreement, and
(C) will use such grant to supplement, not
supplant, spending by such State, such political
subdivision, and private partners to improve access to
and enhance the quality of early education.

SEC. 4. SELECTION OF APPLICANTS TO RECEIVE GRANTS.

In making grants under this Act, the Secretary shall give priority
to eligible applicants that--
(1) are, in the judgment of the Secretary, most likely to
increase the number of employees and members who receive an
Early Education Benefit through their employers and unions,
(2) propose innovative public-private partnerships that
will carry out early education programs that are likely to be
replicated,
(3) are likely to be sustainable beyond the period during
which such grant is expended,
(4) are developed in consultation with child care resource
and referral agencies and networks, and with employers and
unions,
(5) demonstrate the intention and ability to provide--
(A) with funds to be expended for the use described
in section 5(1), Early Education Benefits through Early
Education Benefit Agreements to a significant number of
employees of private employers with fewer than 50
employees, or
(B) with funds to be expended for the use described
in section 5(2), Early Education Start-up Grants to
private employers with fewer than 50 employees, and
(6) have experience working on early childhood
issues and working in partnership with the business
community, or have an agreement to implement the
program funded by a grant made under section 2 through
a nonprofit entity with such experience.

SEC. 5. USES OF FUNDS.

A recipient of a grant made under section 2 shall use such grant--
(1) to enter into Early Education Benefit Agreements to
provide Early Education Benefits, or
(2) to provide funds to private partners to establish new
early education facilities,
except that not more than 5 percent of such grant may be used to pay
administrative costs incurred by such recipient to carry out this Act,
including providing outreach to private partners.

SEC. 6. EARLY EDUCATION BENEFIT AGREEMENTS.

(a) Eligibility.--To be eligible to receive funds to be used for
the purpose specified in section 5(1) from a grant made under section
2, a private partner, or consortia of private partners, shall enter
into an Early Education Benefit Agreement with the recipient of such
grant that includes the following:
(1) An assurance that such private partner, or such
consortia, will pay not less than--
(A) /3\ of the cost of such Early Education
Benefit, or
(B) /5\ of such cost if such private partner, or
such consortia, creates a new early education facility
that--
(i) serves children less than 2 years of
age or children with disabilities, or
(ii) is available during nontraditional
work hours.
(2) An assurance that such private partner, or such
consortia, shall offer such Early Education Benefit on a
priority basis to such employees or such members who have lower
incomes if such Early Education Benefit is not offered to all
such employees or all such members.
(3) An assurance that if such private partner, or such
consortia, requires that such Early Education Benefit received
by an employee or member be expended at a limited number of
sites where early education (including child care, preschool,
and other early childhood programs) is provided, then
there shall be at least 1 provider of early education (including child
care, preschool, and other early childhood programs) for which such
Early Education Benefit may be expended, that is--
(A) located at or near the residence or place of
employment of such employee or such member, and
(B) accredited by the National Association for the
Education of Young Children or the National Association
for Family Child Care, or taking steps to obtain such
accreditation.
(4) An assurance that early education paid for in whole or
in part by such Early Education Benefit will be provided by a
provider that is licensed or regulated by the State.
(5) A detailed description of--
(i) the nature of the Early Education Benefit to be
provided,
(ii) the respective financial contributions of such
private partner, or such consortia, and such grant
recipient, and the procedures by which such
contributions will be made,
(iii) the number of employees or members expected
to receive the Early Education Benefit provided under
such Agreement, and
(iv) the estimated total cost of such Benefit to
such private partner (or such consortia), such grant
recipient, and such employees or such members.
(b) Selection of Private Partners To Enter Into Early Education
Benefit Agreements.--In selecting private partners with which to enter
into Early Education Benefit Agreements, a recipient of a grant made
under section 2 shall give priority to--
(1) private partners that will make larger financial
contributions to the Early Education Benefit,
(2) private partners with fewer employees or members,
(3) private partners that will make an Early Education
Benefit available to employees and members on a sliding scale
inversely proportional to their level of earned income, and
(4) private partners that have a history of personnel
policies and practices that enable their employees or their
members to balance work commitments with family obligations.

SEC. 7. EARLY EDUCATION START-UP GRANTS.

(a) Eligibility To Receive Funds.--To be eligible to receive funds
for the use specified in section 5(2) from a grant made under section
2, a private partner shall agree--
(1) to subsidize attendance at the proposed new early
education facility for children of lower-paid employees or
members, and
(2) to pay not less than /3\ of the cost of acquiring,
building, and renovating physical premises to be used as such
facility.
(b) Selection of Private Partners To Receive Funds.--In providing
funds to private partners from a grant received for the use specified
in section 5(2), a recipient of a grant made under section 2 shall give
priority to--
(1) private partners that will create a facility to provide
early education that--
(A) serves children less than 2 years of age or
children with disabilities, or
(B) is available during nontraditional hours during
which their parents are employed,
(2) private partners that will operate such a facility that
is accredited, has a low ratio of children to adults, or
demonstrates other facts that show such facility offers an
early education program of high quality,
(3) private partners that will pay with nongovernmental
funds a larger share of the cost of the use for which the Early
Education Start-up Grant funds will be expended,
(4) private partners that have fewer employees or members,
and
(5) private partners that have a history of personnel
policies and practices that enable their employees or members
to balance work commitments with family obligations.

SEC. 8. REPORTS.

(a) Reports by Grantees.--The Secretary shall issue rules that
require each recipient of a grant made under section 2 to submit
annually to the Secretary a report that includes the following
information for the fiscal year for which such report is submitted:
(1) The number of Early Education Benefit Agreements
participated in and Start-Up Grants made.
(2) Information about the private partners, including the
industry of which they are a part and their size.
(3) Information about the number of employees who are both
offered and are receiving Early Education Benefits as a result
of such grant,including the number and average incomes of
employees who are receiving Early Education Benefits and the
number of employees who were offered and declined Early
Education Benefits.
(4) Information about the amount of private spending on
Early Education Benefits and on the investment in new early
education facilities leveraged by the grants.
(5) If appropriate and available, information about whether
and at what level private partners have continued to provide
Early Education Benefits after the conclusion of the grantee's
participation in an Early Education Benefit Agreement.
(b) Reports by the Secretary.--The Secretary shall submit to the
Congress biennially a report that includes the following information
for the period of 2 fiscal years for which such report is submitted:
(1) Summaries of the reports received under subsection (a)
by the Secretary for such period.
(2) A description of the implementation of this Act, and
its impact on employees' access to early education programs for
their children, during such period.

SEC. 9. DEFINITIONS.

For purposes of this Act:
(1) Child.--The term ''child'' means an individual who is
less that 6 years of age.
(2) Early Education Benefit.--The term ''Early Education
Benefit'' means assistance, in cash or in kind, to pay any part
of the cost incurred by employees and union members to obtain
early education (including child care, preschool, and other
early childhood programs) for their children.
(3) Early Education Benefit Agreement.--The term ''Early
Education Benefit Agreement'' means a contract under which a
recipient of a grant under section 2 and a private partner that
receives from such recipient funds provided for the use
described in section 5(1) agree to provide jointly an Early
Education Benefit for children of the members or employees of
such private partner.
(4) Private Partner.--The term ''private partner'' means a
private employer, labor union, and consortia of employers or
labor unions.
(5) Secretary.--The term ''Secretary'' means the Secretary
of Health and Human Services.

SEC. 10. AUTHORIZATION OF APPROPRIATIONS.

There are authorized to be appropriated to carry out this Act such
sums as may be necessary for fiscal years 2003 through 2007.

Answer: Early Education Employee Benefit Act of 2002 - Authorizes the Secretary of Health and Human Services (HHS) to make competitive matching grants to States and local governments to: (1) enter Early Education Benefit Agreements with private partners to provide part of the cost of Early Education Benefits, which reduce costs incurred by employees and union members to obtain early education (including child care, preschool, and other early childhood programs); or (2) make Early Education Start-Up Grants to assist private partners to pay part of the cost of acquiring, building, and renovating physical premises to be used as new early education facilities, if such partners subsidize attendance at those facilities for children of lower-paid employees or union members.

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.