Reimbursement and CDC Recognition for the Medicare Diabetes Prevention Program: Pre-Covid Rules and CMS Current PHE Waivers

Reimbursement and CDC Recognition for the Medicare Diabetes Prevention Program: Pre-Covid Rules and CMS Current PHE Waivers is organized by Dietitian Central.

Live Event Date: Feb 02, 2023
Expiration Date: May 31, 2024

Description:
Diabetes affects more than 25% of Americans aged 65 or older, and its prevalence is projected to increase approximately two-fold for all U.S. adults (ages 18-79) by 2050 if current trends continue. CMS estimates that Medicare spent $42 billion more in the single year of 2016 on beneficiaries with diabetes than it would have spent if those beneficiaries did not have diabetes. Per-beneficiary, Medicare spent an estimated $1,500 more on Part D prescription drugs, $3,100 more for hospital and facility services, and $2,700 more in physician and other clinical services for those with diabetes than those without diabetes. Fortunately, type 2 diabetes can usually be delayed or prevented with health behavior changes that focus on diet and physical activity. The Medicare Diabetes Prevention Program (MDPP) expanded model is a structured behavior change intervention that aims to prevent the onset of type 2 diabetes among Medicare beneficiaries with an indication of prediabetes. This model is an expansion of the Diabetes Prevention Program (DPP) model test, which was tested through the Center for Medicare and Medicaid Innovation's Health Care Innovation Awards. In this webinar, Mary Ann will review the Medicare reimbursement rules for the MDPP, and also the CDC requirements for pending, prelimary and full recognition for any diabetes prevention program, not just one to bill Medicare. RDNs are the perfect healthcare professionals to furnish the MDPP, based on the CDC curriculum for it. All billing rules are reviewed, as well as how suppliers enroll in Medicare to furnish and bill for the MDPP. CMS has allowed many waivers and flexibilities in the rules for the pandemic, many of which will continue even after the PHE.

Learning Objectives:
Upon successful completion of this course, the participant should be able to:
• State the 3 levels of CDC recognition for a Diabetes Prevention Program (DPP) and for the MDPP.
• State the phases of the MDPP, both pre-covid and currently with the CMS waiver; explain what has changed.
• Explain the current MDPP reimbursement rules with regard to all virtual visits.
• Explain the >5% weight loss goal and how beneficiaries can now be weighed that is not in-person.
• State what the beneficiary attendance requirements are for coverage in the 2 phases of the MDPP.
• Explain CDC's requirements for Lifestyle Change Coaches in the DPP and MDPP.
• State the eligibility requirements for Medicare beneficiaries to start the MDPP, and how they differ from the CDC participant eligibility requirements.
• Explain the CMS requirements to become a MDPP "supplier" and thus be able to bill Medicare.
• Review how Medicare reimburses suppliers for the MDPP.
• State the new maximum reimbursement amount now that CMS has redistributed payments.

2.0 Credits