text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Access to Quality Diabetes Education 
  Act of 2013''.
  
  SEC. 2. FINDINGS.
  
      Congress makes the following findings:
              (1) The Centers for Disease Control and Prevention 
          (hereinafter ``CDC'') report that nearly 26,000,000 Americans 
          have diabetes, in addition to an estimated 79,000,000 Americans 
          who have prediabetes, an increase of 24,000,000 Americans with 
          either diabetes or prediabetes since 2008. People with 
          prediabetes are at increased risk of developing Type 2 diabetes 
          or cardiovascular disease.
              (2) Diabetes impacts 8.3 percent of all Americans and 11.3 
          percent of American adults. The CDC estimates that as many as 1 
          in 3 Americans will have diabetes by 2050 if current trends 
          continue.
              (3) According to the American Diabetes Association, the 
          total costs of diagnosed diabetes have risen to $245 billion in 
          2012 from $174 billion in 2007, when the cost was last examined 
          by the CDC. This figure represents a 41 percent increase over a 
          five-year period.
              (4) One in 3 Medicare dollars is currently spent on people 
          with diabetes.
              (5) There were 11.3 million diabetes related emergency room 
          visits in 2008, compared with 9.5 million in 2000, an increase 
          of 11 percent.
              (6) According to the CDC, health care providers are finding 
          statistically significant increases in the prevalence of Type 2 
          diabetes in children and adolescents.
              (7) Diabetes self-management training (hereinafter 
          ``DSMT''), also called diabetes education, provides critical 
          knowledge and skills training to patients with diabetes, 
          helping them manage medications, address nutritional issues, 
          facilitate diabetes-related problem solving, and make other 
          critical lifestyle changes to effectively manage their 
          diabetes. Evidence shows that individuals participating in DSMT 
          programs are able to progress along the continuum necessary to 
          make sustained behavioral changes in order to manage their 
          diabetes.
              (8) A certified diabetes educator is a State licensed or 
          registered health care professional 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.
              (9) Diabetes self-management training has been proven 
          effective in helping to reduce the risks and complications of 
          diabetes and is a vital component of an overall diabetes 
          treatment regimen. Patients who have received training from a 
          certified diabetes educator are better able to implement the 
          treatment plan received from a physician skilled in diabetes 
          treatment.
              (10) Lifestyle changes, such as those taught by certified 
          diabetes educators, directly contribute to better glycemic 
          control and reduced complications from diabetes. Evidence shows 
          that the potential for prevention of the most serious medical 
          complications caused by diabetes to be as high as 90 percent 
          (blindness), 85 percent (amputations), and 50 percent (heart 
          disease and stroke) with proper medical treatment and active 
          self-management.
              (11) In recognition of the important role of DSMT programs, 
          the CDC in 2012 awarded funding to expand the National Diabetes 
          Prevention Program to help prevent the onset of Type 2 diabetes 
          for individuals at high risk.
              (12) The net savings to the Medicare program of ensuring 
          that beneficiaries have access to quality DSMT is estimated to 
          be $2,000,000,000 over 10 years.
              (13) Despite its effectiveness in reducing diabetes-related 
          complications and associated costs, diabetes self-management 
          training has been recognized by the Centers for Medicare & 
          Medicaid Services as an underutilized Medicare benefit, even 
          after more than a decade of coverage.
              (14) Enhancing access to diabetes self-management training 
          programs that are certified as necessary by the patient's 
          treating physician and taught by certified diabetes educators 
          is an important public policy goal that can help improve health 
          outcomes, ensure quality, and reduce escalating diabetes-
          related health costs.
  
  SEC. 3. RECOGNITION OF CERTIFIED DIABETES EDUCATORS AS AUTHORIZED 
                PROVIDERS OF MEDICARE 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 (1), by striking ``by a certified provider 
          (as described in paragraph (2)(A)) in an outpatient setting'' 
          and inserting ``in an outpatient setting by a certified 
          diabetes educator (as defined in paragraph (3)) or by a 
          certified provider (as described in paragraph (2)(A))''; and
              (2) by adding at the end the following new paragraphs:
      ``(3) For purposes of paragraph (1), the term `certified diabetes 
  educator' means an individual--
              ``(A) who is licensed or registered by the State in which 
          the services are performed as a certified diabetes educator; or
              ``(B) who--
                      ``(i) is licensed or registered by the State in 
                  which the services are performed as a health care 
                  professional;
                      ``(ii) specializes in teaching individuals with 
                  diabetes to develop the necessary skills and knowledge 
                  to manage the individual's diabetic condition; and
                      ``(iii) is certified as a diabetes educator by a 
                  recognized certifying body (as defined in paragraph 
                  (4)).
      ``(4) For purposes of paragraph (3)(B)(iii), the term `recognized 
  certifying body' means a certifying body for diabetes educators which 
  is recognized by the Secretary as authorized to grant certification of 
  diabetes educators for purposes of this subsection pursuant to 
  standards established by the Secretary.''.
      (b) Treatment as a Practitioner, Including for Telehealth 
  Services.--Section 1842(b)(18)(C) of the such Act (42 U.S.C. 
  1395u(b)(18)(C)) is amended by adding at the end the following new 
  clause:
              ``(vii) A certified diabetes educator (as defined in 
          section 1861(qq)(3)).''.
      (c) GAO Study and Report.--
              (1) Study.--The Comptroller General of the United States 
          shall conduct a study to identify the barriers that exist for 
          Medicare beneficiaries with diabetes in accessing diabetes 
          self-management training services under the Medicare program, 
          including economic and geographic barriers and availability of 
          appropriate referrals and access to adequate and qualified 
          providers.
              (2) Report.--Not later than 1 year after the date of the 
          enactment of this Act, the Comptroller General of the United 
          States shall submit to Congress a report on the study conducted 
          under paragraph (1).
      (d) AHRQ Development of Recommendations for Outreach Methods and 
  Report.--
              (1) Development of recommendations.--The Director of the 
          Agency for Healthcare Research and Quality shall, through use 
          of a workshop and other appropriate means, develop a series of 
          recommendations on effective outreach methods to educate 
          physicians and other health care providers as well as the 
          public about the benefits of diabetes self-management training 
          in order to promote better health outcomes for patients with 
          diabetes.
              (2) Report.--Not later than 1 year after the date of the 
          enactment of this Act, the Director of the Agency for 
          Healthcare Research and Quality shall submit to Congress a 
          report on the recommendations developed under paragraph (1).
      (e) Effective Date.--The amendments made by this section shall 
  apply to items and services furnished after the end of the 12-month 
  period beginning on the date of the enactment of this Act.
target: Access to Quality Diabetes Education Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to recognize state-licensed or -registered certified diabetes educators or state-licensed or -registered health care professionals who specialize in teaching individuals with diabetes to develop the necessary skills and knowledge to manage the individual's diabetic condition and are certified as a diabetes educator by a recognized certifying body. Directs the Comptroller General (GAO) to study the barriers that exist for Medicare beneficiaries with diabetes in accessing diabetes self-management training services under the Medicare program. Requires the Director of the Agency for Health Care Research and Quality of the Department of Health and Human Services (HHS) to develop a series of recommendations on effective outreach methods to educate primary care physicians and other health care providers as well as the public about the benefits of diabetes self-management training. 
feat_title: Access to Quality Diabetes Education Act of 2013