To amend title XVIII of the Social Security Act to provide coverage under the medicare program for diabetes laboratory diagnostic tests and other services to screen for diabetes.

March 11, 2003

Mrs. LINCOLN (for herself, Ms. COLLINS, and Mr. BINGAMAN) introduced the following bill; which was read twice and referred to the Committee on Finance

To amend title XVIII of the Social Security Act to provide coverage under the medicare program for diabetes laboratory diagnostic tests and other services to screen for diabetes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Access to Diabetes Screening Services Act of 2003'.

SEC. 2. MEDICARE COVERAGE OF DIABETES LABORATORY DIAGNOSTIC TESTS.

(a) COVERAGE- Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended--

(1) in subparagraph (U), by striking `and' at the end;

(2) in subparagraph (V)(iii), by adding `and' at the end; and

(3) by adding at the end the following new subparagraph:

`(W) diabetes screening tests and services (as defined in subsection (ww));'.

(b) SERVICES DESCRIBED- Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection:

`Diabetes Screening Tests and Services

`(ww)(1) The term `diabetes screening tests' means diagnostic testing furnished to an individual at risk for diabetes (as defined in paragraph (2)) for the purpose of early detection of diabetes, including--

`(A) a fasting plasma glucose test; and

`(B) such other tests, and modifications to tests, as the Secretary determines appropriate, in consultation with appropriate organizations.

`(2) For purposes of paragraph (1), the term `individual at risk for diabetes' means an individual who has any, a combination of, or all of the following risk factors for diabetes:

`(A) A family history of diabetes.

`(B) Overweight defined as a body mass index greater than or equal to 25 kg/m 2 .

`(C) Habitual physical inactivity.

`(D) Belonging to a high-risk ethnic or racial group.

`(E) Previous identification of an elevated impaired fasting glucose.

`(F) Identification of impaired glucose tolerance.

`(G) Hypertension.

`(H) Dyslipidemia.

`(I) History of gestational diabetes mellitus or delivery of a baby weighing greater than 9 pounds.

`(J) Polycystic ovary syndrome.

`(3) The Secretary shall establish standards, in consultation with appropriate organizations, regarding the frequency of diabetes screening tests, except that such frequency may not be more often than twice within the 12-month period following the date of the most recent diabetes screening test of that individual.'.

(c) FREQUENCY- Section 1862(a)(1) of the Social Security Act (42 U.S.C. 1395y(a)(1)) is amended--

(1) in subparagraph (H), by striking `and' at the end;

(2) in subparagraph (I), by striking the semicolon at the end and inserting `, and'; and

(3) by adding at the end the following new subparagraph:

`(J) in the case of a diabetes screening test or service (as defined in section 1861(ww)(1)), which is performed more frequently than is covered under section 1861(ww)(3).'.

(d) EFFECTIVE DATE- The amendments made by this section shall apply to tests furnished on or after the date that is 90 days after the date of enactment of this Act.

END