Diabetes Legisation Introduced by Caucus Leadership
Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 2651) This bill will enhance research at the National Institutes of Health on the causes and effects of diabetes in minority communities. Additionally, under the bill, the Centers for Disease Control and Prevention will provide more effective diabetes treatment, prevention, and public education to highly impacted populations. This will include access to effective community interventions like the National Diabetes Prevention Program. Lastly, the bill will strengthen the public health workforce in areas highly impacted by diabetes through efforts by the Health Resources and Services Administration. For long-term improvements, the bill requires a report to Congress on the existing federal activities with respect to diabetes and prediabetes in minority populations followed by a strategic plan to address these disparities over time.
Protecting Access to Diabetes Supplies Act (H.R. 771) This bill would improve the Competitive Bidding Program (CBP) for Durable Medical Equipment and Supplies to ensure Medicare beneficiaries with diabetes have access to the testing supplies of their choice. Specifically, the 50% rule would be strengthened to ensure suppliers actually provide at least 50% of the percent of all types of diabetes test supplies on the market before implementation of the CBP. Additionally, the no-switching rule would be strengthened to prevent suppliers from pressuring beneficiaries into changing their choice of testing supplies and make it easier for beneficiaries who wish to change testing supplies to receive the products of their choice
Medicare CGM Access Act (H.R. 1427) This bill creates a new benefit category under Medicare for continuous glucose monitoring (CGM) devices, identifies beneficiary eligibility, and establishes a fee schedule that reflects market prices and takes into consideration the most recent data. CGMs are physician-prescribed, FDA-approved devices that detect and display glucose levels continuously, and reveal trends in glucose levels that often go unnoticed by using finger-stick measurements alone. Currently, over 95 percent of all private health plans cover CGMs for people with type 1 diabetes, but Medicare does not. Extensive clinical evidence shows use of a CGM improves outcomes, is superior beyond use of a blood glucose monitor alone, and is recommended for use by all leading diabetes professional societies.
Preventing Diabetes in Medicare Act (H.R. 1686) This bill is designed to help beneficiaries diagnosed with pre-diabetes avoid becoming diabetic by providing access to the best possible nutritional advice about how to handle their condition. Under current law, Medicare pays for medical nutrition therapy (MNT) provided by a registered dietitian for beneficiaries with diabetes and renal diseases. Medicare also pays for the screening of diabetes in the Welcome to Medicare Physical. However, Medicare does not cover MNT for beneficiaries diagnosed as having pre-diabetes, and this legislation would fill that hole in beneficiaries’ care.
Access to Quality Diabetes Education Act (H.R. 1726) This bill recognizes state-licensed or –registered certified diabetes educators as providers. It also increases education and outreach to primary care physicians about the importance of Diabetes Self-Management Training (DSMT) for their patients with diabetes. In 1997, Congress authorized DSMT as a Medicare benefit, with the goal of providing a more comprehensive level of support to educate beneficiaries about diabetes and self-management techniques, reduce the known risks and complications of diabetes, and improve overall health outcomes. However, under the DSMT benefit, Congress failed to include as providers certified diabetes educators – the main group of health care professionals who provide most of the essential training and education for this service. This legislation fixes this mistake and ensures diabetics have access to their service.
Medicare Safe Needle Disposal Coverage Act (H.R. 1727) This bill extends Medicare Part D coverage for home-generated needle collection, treatment, and disposal methods, such as FDA-approved sharps containers, needle destruction devices, and sharps-by-mail programs. According to the Food and Drug Administration (FDA), over 9 million home injectors administer at least 3 billion injections outside traditional health care settings. These at-home injectors include people with diabetes and patients receiving home health treatment for allergies, arthritis, and hepatitis B & C, among others. Currently, Medicare Part D provides coverage for insulin syringes and pen needles associated with the injection, but there is no coverage for their safe disposal. This bill recognizes the fact that needle disposal coverage is essential not only for patient safety, but also for the safety of waste removal workers and our communities.
Diabetes Legisation Introduced by Caucus Members
Medicare Diabetes Prevention Act (H.R. 2102) This legislation provides Medicare coverage for the National Diabetes Prevention Program (National DPP) to individuals at high-risk of developing type 2 diabetes. The National DPP evolved from a successful NIH clinical trial that found individuals with prediabetes—those at the highest risk for the disease—can reduce their risk for type 2 diabetes by 58 percent with lifestyle intervention and modest weight loss of 5-7 percent. Seniors were even more successful, decreasing their risk for the disease by 71 percent. Given that half of all seniors have prediabetes, providing coverage for the National DPP, an evidence-based lifestyle intervention, through the Medicare program can reduce the number of beneficiaries who develop type 2 diabetes and its dangerous complications, including cardiovascular disease, stroke, blindness, lower-limb amputation and kidney disease. Avalere Health estimates the legislation would save $1.3 billion over 10 years.
HELLPP Act (H.R. 1221) The Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act would recognize podiatrists as physicians under the Medicaid program, as has been the case in Medicare for more than 40 years. Podiatrists are licensed by their state boards to deliver independent foot and ankle surgical and medical care without any supervision or collaboration requirement. Evidence shows that, when podiatrists deliver foot and ankle care, outcomes are better and hospitalizations are fewer and shorter—thereby saving the health care system billions annually. This bill also includes provisions to improve coordination of care in Medicare’s Therapeutic Shoe Program and strengthen Medicaid program integrity to create budget savings.
National Diabetes Clinical Care Commission Act (H.R. 1192) This bill creates a time-limited commission for the purpose of improving the implementation and coordination of clinical care for patients with pre-diabetes, diabetes and the chronic diseases and conditions that result from diabetes, such as cardiovascular disease, kidney disease, blindness and foot amputations. The Commission is a partnership between private sector experts, including healthcare professionals and patient advocates, and specialists in the Federal agencies most active in clinical care. The Commission will evaluate current federal care management and quality improvement initiatives, identify gaps where new approaches are needed and make recommendations to eliminate duplicative and inconsistent policies and improve the quality of diabetes car and patient outcomes.