Report on enrollee access to diabetes-related services and technologies in Federal health care programs

(a) In general Not later than 1 year after the date of enactment of this Act, the Comptroller General of the United States, in collaboration with the Secretary of Health and Human Services, shall submit to the Committee on Finance and the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives, a report that assesses the barriers individuals face in accessing diabetes technologies and diabetes self-management education and support services across Federal health care programs. The report shall specifically review barriers, which include prior authorization practices, the use of preferred formularies, coverage intensity limitations, and other utilization management techniques, to accessing diabetes technologies and diabetes self-management education and support services faced by individuals enrolled in a Federal health care program, and whether any Federal law, regulation, or policy adversely affects access to those covered services or limits the ability of individuals with diabetes to receive services that align with standards of care. (b) Definitions In this section: (1) Diabetes technologies The term diabetes technologies means items described in section 1861(ww)(5)(D) of the Social Security Act, as added by section 3, and any device, related supplies, and software or algorithm that monitors or manages an individual’s diabetes that is medically necessary for the individual’s diagnosis of diabetes, regardless of whether the device, related supplies, and software or algorithm is covered under part B of title XVIII of the Social Security Act. Such term includes glucose monitors, insulin delivery technologies, related supplies, and software or algorithms. (2) Diabetes self-management education and support services The term diabetes self-management education and support services means services described in section 1861(qq) of the Social Security Act (42 U.S.C. 1395x(qq)). (3) Federal health care program The term Federal health care program means any plan or program that provides health benefits, whether through insurance or otherwise, that is directly funded in whole or in part, by the United States Government, including a Federal health care program (as defined in section 1128B(f) of the Social Security Act (42 U.S.C. 1320a–7b(f))) and a health benefits plan under chapter 89 of title 5, United States Code.