COVERAGE OF DIABETES SCREENING TESTS.

SEC. 613. COVERAGE OF DIABETES SCREENING TESTS.(a) Coverage.—Section 1861(s)(2) (42 U.S.C. 1395x(s)(2)), as amended by section 612(a), is amended—(1) in subparagraph (W), by striking “and” at the end;(2) in subparagraph (X), by adding “and” at the end; and(3) by adding at the end the following new subparagraph:“(Y) diabetes screening tests (as defined in subsection (yy));”.(b) Services Described.—Section 1861 (42 U.S.C. 1395x), as amended by section 612(b), is amended by adding at the end the following new subsection:“Diabetes Screening Tests “(yy)(1) The term ‘diabetes screening tests’ means 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.117 STAT. 2306“(2) For purposes of paragraph (1), the term ‘individual at risk for diabetes’ means an individual who has any of the following risk factors for diabetes:“(A) Hypertension.“(B) Dyslipidemia.“(C) Obesity, defined as a body mass index greater than or equal to 30 kg/m2.“(D) Previous identification of an elevated impaired fasting glucose.“(E) Previous identification of impaired glucose tolerance.“(F) A risk factor consisting of at least 2 of the following characteristics:“(i) Overweight, defined as a body mass index greater than 25, but less than 30, kg/m2.“(ii) A family history of diabetes.“(iii) A history of gestational diabetes mellitus or delivery of a baby weighing greater than 9 pounds.“(iv) 65 years of age or older.“(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) (42 U.S.C. 1395y(a)(1)), as amended by section 612(c), is amended—(1) by striking “and” at the end of subparagraph (K);(2) by striking the semicolon at the end of subparagraph (L) and inserting “, and”; and(3) by adding at the end the following new subparagraph:“(M) in the case of a diabetes screening test (as defined in section 1861(yy)(1)), which is performed more frequently than is covered under section 1861(yy)(3);”.(d) Effective Date.—The amendments made by this section shall apply to tests furnished on or after January 1, 2005.