S. 626Senate109th Congress (2005-2007)In Committee

Diabetes Self Management Training Act of 2005

Sponsored by Ben NelsonSen. Ben Nelson (D-NE)
Introduced March 15, 2005

Legislative Activity

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2 earlier actions
SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance.

March 15, 2005

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SenateIntro Referral

Introduced in Senate

March 15, 2005

SenateIntro Referral

Sponsor introductory remarks on measure. (CR S2740)

March 15, 2005

SenateIntro Referral

Read twice and referred to the Committee on Finance.

March 15, 2005

Floor Debate

24 members

What members said about S. 626 on the floor

9 Republicans15 Democrats
Orrin G. Hatch
Sen. Orrin G. HatchR-UT · Mar 15, 2005

Mr. President, I rise today to introduce the Paiute Indian Tribe Land Conveyance Act of 2005. This bill would authorize the Secretary of the Interior to convey or transfer four small Paiute trust…

Patrick J. Leahy
Sen. Patrick J. LeahyD-VT · Mar 15, 2005

Mr. President, this week marks the first national ``Sunshine Week.'' The centerpiece of this week is Freedom of Information Day, which falls on March 16, the anniversary of James Madison's birthday.…

Max Baucus
Sen. Max BaucusD-MT · Mar 15, 2005

Mr. President, I am pleased to again join with my friend, Senator Hatch, in introducing legislation to make a permanent commitment to research-intensive businesses in the United States. This…

Charles E. Schumer
Sen. Charles E. SchumerD-NY · Mar 15, 2005

Mr. President, I am pleased to come to the floor today and introduce legislation that would allow a $1,000 refundable tax credit for the true heroes in our society: those brave and dedicated…

Christopher J. Dodd
Sen. Christopher J. DoddD-CT · Mar 15, 2005

Mr. President, I rise with our colleague, Senator Lieberman, to reintroduce two pieces of legislation intended to improve the process by which the Federal Government considers petitions of American…

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Earl Blumenauer
Rep. Earl BlumenauerD-OR-3 · Mar 20, 2005

Mr. Speaker, this legislation provides a clear lesson for the American public about how Congress and American politics operate today. Make no mistake, this is not about what Terri Schiavo wants. It…

Richard G. Lugar
Sen. Richard G. LugarR-IN · Mar 15, 2005

Mr. President, I rise today to introduce the Health Promotion FIRST, Funding Integrated Research, Synthesis and Training, Act, legislation to provide the foundation for solid planning and a…

Lynn C. Woolsey
Rep. Lynn C. WoolseyD-CA-6 · Mar 20, 2005

Mr. Speaker, there is no more difficult decision for a family than to remove a loved one from life support. My heart goes out to the Schiavo family in this very personal and difficult time. However,…

Edward M. Kennedy
Sen. Edward M. KennedyD-MA · Mar 15, 2005

Mr. President, today, Senators Murray, Cantwell, Corzine, Kerry, Lieberman, Sarbanes, Mikulski, Boxer, Lautenberg, Durbin, Schumer, Levin, Feinstein, Harkin, Dodd and I are re- introducing the Equal…

Roscoe G. Bartlett
Rep. Roscoe G. BartlettR-MD-6 · Mar 20, 2005

Mr. Speaker, Congress typically writes laws with a broad application, but sometimes a special situation, such as this one, requires unusual legislative action. Life is sacred. Many across America…

Michael M. Honda
Rep. Michael M. HondaD-CA-15 · Mar 20, 2005

Mr. Speaker, I rise today to address S. 686 for the Relief of the Parents of Theresa Marie Schiavo. Numerous courts have reviewed the tragic case of Terri Schiavo, and all have agreed that the right…

Kent Conrad
Sen. Kent ConradD-ND · Mar 15, 2005

Mr. President, I rise today to introduce legislation to make permanent the 15-year depreciation period for leasehold improvements that was enacted on a temporary basis as part of the American Jobs…

Bart Stupak
Rep. Bart StupakD-MI-1 · Mar 20, 2005

Mr. Speaker, as one of 203 Democrat and Republican Members of Congress who voted in favor of S. 686, a private bill for the Relief of the Parents of Theresa Marie Schiavo, I am pleased that President…

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J. Dennis Hastert
Rep. J. Dennis HastertR-IL-14 · Mar 20, 2005

Mr. Speaker, we come here with a heavy heart. I urge the Members of this House to do our duty to pass the Schiavo Act. Its purpose is simple--to allow the Federal courts to review this matter in the…

John B. Shadegg
Rep. John B. ShadeggR-AZ-3 · Mar 20, 2005

Mr. Speaker, thank you for giving me an opportunity to voice my thoughts on this significant issue. This Nation was founded to preserve the sacred rights of mankind: life, liberty, and the pursuit of…

Gene Green
Rep. Gene GreenD-TX-29 · Mar 20, 2005

Mr. Speaker, I support this legislation, S. 686, for the relief of the parents of Terri Schiavo. This deeply personal family matter has come to our attention and been acted upon by Congress when the…

Jerry Weller
Rep. Jerry WellerR-IL-11 · Mar 20, 2005

Mr. Speaker, my remarks today are to commend the United States House of Representatives for taking such swift and just action during the early hours of Monday, March 21st when this body passed S. 626…

Major R. Owens
Rep. Major R. OwensD-NY-11 · Mar 20, 2005

Mr. Speaker, we have just set a frightening precedent in the halls of Congress by interfering in the life of an individual. Yet we show little compassion for the scores of families who do not have…

Carolyn C. Kilpatrick
Rep. Carolyn C. KilpatrickD-MI-13 · Mar 20, 2005

Mr. Speaker, I regret that Congress is being called in to this special session while official business requires me to be elsewhere at this time. However, I wish to insert these remarks for the Record…

Jeb Hensarling
Rep. Jeb HensarlingR-TX-5 · Mar 20, 2005

Mr. Speaker, as the elected representatives of the American people, we have no greater responsibility than defending the lives and liberties of the most vulnerable among us. Today, both the…

Nathan Deal
Rep. Nathan DealR-GA-10 · Mar 20, 2005

Mr. Speaker, I would like to commend the Leadership in the House and Senate for working together for a rapid compromise on legislation to allow for the relief of the parents of Terri Schiavo, and I…

Dennis Moore
Rep. Dennis MooreD-KS-3 · Mar 20, 2005

Mr. Speaker, since February 1990, Terri Schiavo and her family have been coping with a tragic situation involving the most sensitive and difficult question imaginable. Congress and the American…

Tom Feeney
Rep. Tom FeeneyR-FL-24 · Mar 20, 2005

Mr. Speaker, as members of Congress, we have a moral obligation to protect innocent life and not stand idly by while an activist judge seeks to use extreme measures to destroy the life of an innocent…

Robert E. Andrews
Rep. Robert E. AndrewsD-NJ-1 · Mar 20, 2005

Mr. Speaker, I am deeply saddened over the pain and suffering of Ms. Schiavo and her family. This is a tragedy of great depth. I cannot imagine the pain that Ms. Schiavo has endured. As a husband, I…

Bill Text

Latest available legislative text

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Introduced in SenateIssued March 15, 2005

II

109th CONGRESS

1st Session

S. 626

IN THE SENATE OF THE UNITED STATES

March 15, 2005

Mr. Nelson of Nebraska (for himself and Mrs. Hutchison) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to improve access to diabetes self management training by designating certified diabetes educators who are recognized by a nationally recognized certifying body and who meet the same quality standards set forth for other providers of diabetes self management training, as certified providers for purposes of outpatient diabetes self-management training services under part B of the medicare program.

1.

Short title

This Act may be cited as the Diabetes Self Management Training Act of 2005.

2.

Findings

Congress makes the following findings:

(1)

Diabetes is widely recognized as one of the top public health threats facing our Nation today. More than 18,000,000 Americans are currently living with diabetes and that number is expected to double by the year 2050. Diabetes is the sixth leading cause of death in the United States, causing more than 200,000 deaths each year.

(2)

Diabetes occurs in two forms. Type 1 diabetes is caused by the body’s inability to produce insulin, a hormone that allows glucose to enter and fuel cells. Type 2 diabetes occurs when the body fails to make enough insulin or fails to properly use it. Type 1 diabetes typically develops in childhood or adolescence and accounts for only 5 to 10 percent of cases of diabetes. Type 2 diabetes accounts for 90 to 95 percent of diabetes cases and most often appears among people older than 40. It is especially common in the medicare population, as 1 in 5 adults over age 65 has type 2 diabetes.

(3)

Diabetes is a costly disease. In 2002, diabetes accounted for $132,000,000,000 in direct and indirect health care costs. It is especially costly for the medicare program. Individuals with diabetes represent approximately 20 percent of medicare beneficiaries but account for more than 30 percent of fee-for-service medicare expenditures.

(4)

People with type 1 diabetes are required to take daily insulin injections to stay alive. While some people with type 2 diabetes need daily insulin injections, others with type 2 diabetes can control their diabetes through healthy meal plans, exercise, and, for some, oral medications. Diabetes self management training (in this section referred to as DSMT), also called diabetes education, provides knowledge and skills training to patients with diabetes, helping them identify barriers, facilitate problem solving, and develop coping skills to effectively manage their diabetes. 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)

DSMT has been proven effective in helping to reduce the risks and complications of diabetes. In 2002, the Diabetes Prevention Program study found that participants (all of whom were at increased risk of developing type 2 diabetes) who made lifestyle changes, such as those taught in DSMT programs, reduced their risk of getting type 2 diabetes by 58 percent. Lifestyle intervention worked in all of the groups but it worked particularly well in people aged 60 and older, reducing the development of diabetes by 71 percent. Similarly, studies have found that patients under the care of a certified diabetes educator are better able to control their diabetes and report improvement in their health status. Congress recognized the value of DSMT by creating medicare coverage for this benefit under the Balanced Budget Act of 1997.

(6)

There are currently more than 20,000 diabetes educators in the United States, most of whom are certified diabetes educators credentialed by the National Certification Board for Diabetes Educators (NCBDE). Eligibility for certification as a diabetes educator requires prerequisite qualifying professional credentials in specified health care professions and professional practice experience that includes a minimum number of hours of experience in DSMT. Certified diabetes educators must also pass a rigorous national examination and periodically renew their credentials. Certified diabetes educators are uniquely qualified to provide DSMT under the medicare program.

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 , or a certified diabetes educator (as defined in paragraph (3)) who is credentialed by a nationally recognized certifying body for diabetes educators before the semicolon at the end; and

(B)

in subparagraph (B), by striking a physician through meets applicable and inserting the following: a physician, or such other individual or entity, or a certified diabetes educator meets the quality standards described in this paragraph if the physician, other individual or entity, or certified diabetes educator meets quality standards established by the Secretary, except that the physician, other individual or entity, or certified diabetes educator shall be deemed to have met such standards if the physician, other individual or entity, or certified diabetes educator meets applicable; and

(2)

by adding at the end the following new paragraph:

(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)

has met all criteria for initial certification, including a prerequisite qualifying professional credential in a specified health care profession, has professional practice experience in diabetes self-management training that includes a minimum number of hours of diabetes self-management training, and has passed a national examination offered by a certifying body recognized as entitled to grant certification to diabetes educators; and

(C)

has periodically renewed certification status following initial certification.

.

(b)

GAO study and report

(1)

Study

The Comptroller General of the United States shall conduct a study to identify the barriers that exist for individuals with diabetes in accessing diabetes self management training, including economic and geographic barriers and availability of appropriate referrals and access to adequate, qualified providers.

(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 (1).

(c)

Effective date

The amendments made by subsection (a) shall apply to diabetes outpatient self-management training services furnished on or after the date that is 6 months after the date of enactment of this Act.