CMS Dealing with Stress to Add Telehealth to Diabetes Prevention Packages

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By Eric Wicklund

March 31, 2021 – The Alliance for Connected Care is conducting new lobbying to include telemedicine in a Medicare-funded diabetes prevention program.

The organization lays down supporters behind a letter asking Health and Human Services Secretary Xavier Becerra to make virtual visits to the Medicare Diabetes Prevention Program (MDPP) for the remainder of the coronavirus pandemic emergency in the area public health and work on longer term reforms “that would make connected health an integral part of the program.

The original diabetes prevention program was developed by the National Institutes of Health’s National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) and focused on one-to-one and one-to-one tuition. Based on this model administered by the Centers for Disease Control and Prevention, CMS created the National Diabetes Prevention Program for Medicare Beneficiaries and launched this program in 2018.

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There are now around 70 health care providers listed on the CDC’s DPP website, although only a handful have been recognized as evidence that their online programs achieve recognized benchmarks for activity and weight loss. A growing number of programs use virtual nursing however, to expand the reach of the program and make the most of its limited resources, they do so without reimbursement from Medicare, which prevents a significant portion of the population from taking advantage of the program.

CMS has been under pressure to include virtual care in the program for years, but has so far resisted reporting reported concerns that telehealth is not a viable alternative to in-person treatment. The agency had considered adding virtual reporting to the doctors’ fee schedule for 2021 before withdrawing.

In the letter, Allianz points out the personal care challenges posed by the COVID-19 crisis, as well as the staggering number of people – roughly one in three Americans – who have prediabetes and could develop the chronic disease if they weren’t treated.

“It is generally accepted that quarantines during PHE have led to increased weight gain and thus an increased risk of type 2 diabetes,” the letter said. “In addition, the pressures of the pandemic have severely affected the already financially strained personal diabetes prevention programs, causing many Medicare beneficiaries to lose access to DPP services.”

“Given the persistent and worsening prediabetes challenges for seniors, the expectation that the PHE will last through 2021, and the discontinuation of many personal DPP programs, we believe that CMS must act immediately to ensure access to these services,” concludes the letter. “We believe the Department of Health and Human Services should immediately use its emergency agency to remove the personal requirements for the remainder of the COVID-19 PHE from Medicare’s DPP services. We therefore strongly recommend using data from this extension to evaluate the benefits of a permanent extension of virtual MDPP services. “