Sec. 2. Findings

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Congress makes the following findings: 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. 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. 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. One in 3 Medicare dollars is currently spent on people with diabetes. There were 11.3 million diabetes related emergency room visits in 2008, compared with 9.5 million in 2000, an increase of 11 percent.

According to the CDC, health care providers are finding statistically significant increases in the prevalence of Type 2 diabetes in children and adolescents. 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. 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.

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. 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. 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.

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. 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. 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.