PREVENT DIABETES Act
- Bill Number
- H.R. 1523
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-02-24: 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.
- Last Updated
- 2026-07-01T08:08:19Z
AI-Generated Summary
Purpose of the Legislation
The PREVENT DIABETES Act (H.R. 1523) aims to expand access to diabetes prevention services under Medicare by allowing fully virtual (online) delivery options. It updates regulations to integrate virtual suppliers into the Medicare Diabetes Prevention Program (MDPP) Expanded Model, which is a test program under Medicare to help prevent type 2 diabetes through lifestyle coaching.
Key Provisions
- Timeline and Scope: By January 1, 2026, the Secretary of Health and Human Services (HHS) must revise Medicare regulations (in parts 410 and 424 of title 42, Code of Federal Regulations) to allow virtual participation in the MDPP from January 1, 2026, through December 31, 2030.
- Virtual Participation Allowed: Entities can join the MDPP solely by providing online services using synchronous (real-time, like video calls) or asynchronous (not real-time, like recorded sessions) technology or telecommunications, as long as they meet standard enrollment requirements for MDPP suppliers (organizations approved to deliver the program).
- Administrative and Billing Rules:
- The entity's official address for administrative purposes will be the one listed in the Diabetes Prevention Recognition Program (a CDC program that certifies diabetes prevention providers).
- Virtual suppliers can bill Medicare for services even if the beneficiary (participant) is in a different state from the supplier at the time of service—no location-based restrictions apply.
- Enrollment Flexibility: Removes any limits on how many times an individual Medicare beneficiary can enroll in the MDPP, allowing repeat participation as needed.
Significant Changes to Existing Law
- From In-Person to Virtual: Current MDPP rules emphasize in-person or hybrid delivery; this bill shifts to permit fully online options, broadening how services are provided without requiring physical locations.
- Interstate Billing: Previously, billing might be restricted if services cross state lines; the bill eliminates this barrier for virtual MDPP services.
- No Enrollment Caps: Introduces unlimited re-enrollment, changing from any prior limits that might have restricted repeat access to the program.
These changes build on the MDPP framework established in a 2023 federal rule under the Social Security Act's innovation center (section 1115A).
Potential Impacts
- On Government Agencies: HHS and the Centers for Medicare & Medicaid Services (CMS) will need to update regulations, monitor virtual suppliers, and process more interstate claims, potentially increasing administrative workload but also expanding preventive care reach.
- On Citizens: Medicare beneficiaries at risk for type 2 diabetes (e.g., those with prediabetes) gain easier access to evidence-based lifestyle coaching via online platforms, which could improve participation rates, especially for rural or mobility-limited individuals. This may lead to better health outcomes and lower long-term diabetes-related costs.
- On International Relations: No direct impacts, as the bill focuses on domestic Medicare policy.
Main Stakeholders Affected
- Medicare Beneficiaries: Primary beneficiaries, particularly older adults or those with prediabetes, who can now access virtual coaching more conveniently.
- MDPP Suppliers: Organizations certified under the CDC's Diabetes Prevention Recognition Program, including new virtual providers, who gain opportunities to participate and bill Medicare without geographic limits.
- Government Entities: HHS and CMS, responsible for implementation; indirectly, the CDC through its recognition program standards.
- Healthcare Providers: Lifestyle coaches and diabetes prevention experts who deliver MDPP services, potentially shifting to digital formats.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens telehealth integration in Medicare by aligning MDPP with broader post-pandemic virtual care expansions, ensuring compliance with enrollment standards while reducing barriers. No conflicts with existing fraud protections, as suppliers must still meet certification.
- Constitutional: No apparent issues; the bill operates within Congress's authority over federal spending and health programs under the Social Security Act.
- Political: Promotes preventive health equity and technology use in aging populations, potentially appealing across party lines for cost-saving measures (diabetes prevention can reduce Medicare expenditures). It may encourage further digital health innovations but requires bipartisan committee approval (Energy and Commerce, Ways and Means) for passage.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (8)
Rep. Bilirakis, Gus M. [R-FL-12], Rep. Crow, Jason [D-CO-6], Rep. Schrier, Kim [D-WA-8], Rep. Nunn, Zachary [R-IA-3], Rescom. Hernández, Pablo Jose [D-PR-At Large], Rep. Goodlander, Maggie [D-NH-2], Rep. Walkinshaw, James R. [D-VA-11], Rep. Suozzi, Thomas R. [D-NY-3]
Recent Actions
- 2025-02-24: 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.
- 2025-02-24: 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.
- 2025-02-24: Introduced in House
- 2025-02-24: Introduced in House
Bill Versions
- Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act — issued 2025-02-24 — PDF (4 pages)