PREVENT DIABETES Act

I 117TH CONGRESS 1ST SESSION H. R. 2807 To permit Centers for Disease Control and Prevention-recognized virtual diabetes prevention program suppliers to be included in the Medicare Diabetes Prevention Program Expanded Model conducted by the Center for Medicare and Medicaid Innovation under section 1115A of the Social Security Act (42 U.S.C. 1315a). IN THE HOUSE OF REPRESENTATIVES APRIL 22, 2021 Mr. RICE of South Carolina (for himself, Ms. DEGETTE, Mr. REED, and Mr. BUTTERFIELD) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To permit Centers for Disease Control and Prevention-recog- nized virtual diabetes prevention program suppliers to be included in the Medicare Diabetes Prevention Pro- gram Expanded Model conducted by the Center for Medi- care and Medicaid Innovation under section 1115A of the Social Security Act (42 U.S.C. 1315a). Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 18:07 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2807.IH H2807 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 2807 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Promoting Responsible 2 and Effective Virtual Experiences through Novel Tech- 3 nology to Deliver Improved Access and Better Engage- 4 ment with Tested and Evidence-based Strategies Act’’ or 5 the ‘‘PREVENT DIABETES Act’’. 6 SEC. 2. INCLUSION OF VIRTUAL DIABETES PREVENTION 7 PROGRAM SUPPLIERS IN MDPP EXPANDED 8 MODEL. 9 (a) IN GENERAL.—Not later than January 1, 2022, 10 the Secretary shall revise the regulations under part 410 11 and section 424.200–.518 of title 42, Code of Federal 12 Regulations (or any successor regulations), to permit any 13 diabetes prevention lifestyle change program, including 14 any online or virtual diabetes prevention program, that 15 has met the standards for full recognition by the CDC— 16 (1) to apply to be a MDPP supplier; and 17 (2) upon a successful application, to participate 18 in the MDPP Expanded Model described in the final 19 rule published in the Federal Register on November 20 15, 2017, entitled ‘‘Medicare Program; Revisions to 21 Payment Policies Under the Physician Fee Schedule 22 and Other Revisions to Part B for CY 2018; Medi- 23 care Shared Savings Program Requirements; and 24 Medicare Diabetes Prevention Program’’, in accord- 25 ance with this section. 26 VerDate Sep 11 2014 18:07 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2807.IH H2807 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 2807 IH (b) VIRTUAL DIABETES PREVENTION PROGRAM SUP- 1 PLIERS.—A virtual diabetes prevention program supplier 2 participating in the MDPP Expanded Model shall be sub- 3 ject to the same standards as in-person MDPP suppliers 4 participating in such program, except— 5 (1) the administrative location of a virtual dia- 6 betes prevention program supplier shall be the ad- 7 dress of the supplier on file under the Diabetes Pre- 8 vention Recognition Program of the CDC; 9 (2) a virtual diabetes prevention program sup- 10 plier shall not be required to report a change in its 11 administrative location except when such supplier’s 12 address on file under the Diabetes Prevention Rec- 13 ognition Program has changed; and 14 (3) a virtual diabetes prevention program sup- 15 plier shall not be prohibited from submitting or re- 16 ceiving payment for a claim for virtual diabetes pre- 17 vention program services because the beneficiary was 18 not present in the same State or country as such 19 supplier or service. 20 (c) DIABETES PREVENTION PROGRAM SUPPLIER 21 SCREENING LEVEL.—The supplier enrollment screening 22 level applicable to a virtual diabetes prevention program 23 supplier shall be at a ‘‘high’’ categorical risk in accordance 24 VerDate Sep 11 2014 18:07 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2807.IH H2807 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 2807 IH with section 424.518(c)(2) of title 42, Code of Federal 1 Regulations (or any successor regulations). 2 (d) CLARIFICATION.—Notwithstanding any provision 3 of this law, the MDPP Expanded Model, upon the inclu- 4 sion of virtual diabetes prevention program suppliers, shall 5 continue to be an expanded model under section 1115A 6 of the Social Security Act (42 U.S.C. 1315a), unless the 7 Secretary determines, based on performance data from the 8 MDPP Expanded Model, that continued testing would be 9 inconsistent with the requirements set forth in subsection 10 (c) of such section 1115A. 11 (e) OTHER TESTING.—Nothing in this section shall 12 limit the Secretary from developing and testing additional 13 models that utilize virtual technology or deliver health care 14 services through virtual means. 15 (f) DEFINITIONS.—In this section: 16 (1) CDC.—The term ‘‘CDC’’ means the Cen- 17 ters for Disease Control and Prevention. 18 (2) MDPP.—The term ‘‘MDPP’’ means the 19 Medicare Diabetes Prevention Program. 20 (3) SECRETARY.—The term ‘‘Secretary’’ means 21 the Secretary of Health and Human Services. 22 (4) VIRTUAL DIABETES PREVENTION PROGRAM 23 SUPPLIER.—The term ‘‘virtual diabetes prevention 24 program supplier’’ means a supplier, that meets the 25 VerDate Sep 11 2014 18:07 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2807.IH H2807 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 2807 IH standards for full recognition by the CDC, of diabe- 1 tes prevention program services that are delivered 2 via a synchronous or asynchronous technology or 3 telecommunications. 4 Æ VerDate Sep 11 2014 18:07 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H2807.IH H2807 pamtmann on DSKBC07HB2PROD with BILLS