By Eric Wicklund
April 26, 2021 – Legislators are again asked to add telehealth services to Medicare’s diabetes prevention program to provide healthcare providers with more tools to improve the health and wellbeing of millions of people at risk of chronic diseases.
Four members of Congress last week passed the Act to Promote Responsible and Effective Virtual Experiences through Novel Technologies to Enable Improved Access and Engagement to Tested and Evidence-Based Strategies (PREVENT DIABETES) that would enable Medicare coverage of affiliated health services in the MDPP .
The original diabetes prevention program was developed by the National Institutes of Health’s National Institute on Diabetes and Digestive and Kidney Diseases (NIDDK) and focused on one-on-one and one-on-one teaching to help reduce weight and improve lifestyle choices. Based on this model administered by the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services created the National Diabetes Prevention Program for Medicare Beneficiaries and launched this program in 2018.
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However, the extended MDPP model does not reimburse health care providers for the use of telemedicine to connect with and coach patients. CMS has said in the past that virtual care in the diabetes prevention program has not been shown to result in significant weight loss or reduce costs.
Proponents of Telehealth and mHealth disagree and have been campaigning to add these services for years. A virtual platform would reach far more people at risk and allow providers to make better use of limited resources.
Many diabetes prevention programs use virtual care, and a number of private payers support the service. Medicare coverage, however, would open the program to millions of new people, especially in underserved areas and populations where diabetes is prevalent.
“Expanding virtual access to the diabetes prevention program is incredibly important as it is an important Medicare service,” said Tom Reed (R-NY), a co-sponsor of the law and co-chair of the Congressional Diabetes Caucus. said in a press release introducing the new bill. “In this way, we are ensuring that more Americans can use the information resources they need to make healthy decisions.”
The same bill was passed in the U.S. Senate last September, but that bill, like so many others related to telemedicine, failed to get the mark.
As with last year’s bill, this one also has strong support. Among those supporting the effort are ACT | The App Association, American Diabetes Association, American Medical Association, American Telemedicine Association, and Alliance for Connected Care sent out a letter earlier this month asking Health Secretary Xavier Becerra to stop virtual care during the emergency in the area public health created by the coronavirus pandemic and “work on longer term reforms” that would make connected health an integral part of the program.
“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,” concluded 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. “
