Medicare Diabetes Prevention Program Update

Medicare Diabetes Prevention Program Update

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Physician Fee Schedule to expand the Diabetes Prevention Program beginning January 1, 2018. This is the first time a preventive service model from the CMS Innovation Center will be expanded into the Medicare program (see Medicare Diabetes Prevention Program [MDPP]).  

On November 2, CMS announced the first final rule that describes aspects of the expansion that will enable organizations, including those new to Medicare, to prepare for enrollment into Medicare as MDPP suppliers. Finalized policies include the definition of the MDPP benefit, beneficiary eligibility criteria, and supplier eligibility and enrollment criteria. Future rulemaking will address policies related to payment, virtual providers, and other program integrity safeguards. The final rule will be published on November 15. Refer to pages 1019-1108 for information on the MDPP. 

Upcoming Webinar

CMS will host a webinar on November 30, 1:30-3:00 pm EST, to provide a high-level overview of the final rule.  Participants are encouraged to review the rule prior to the webinar. Registration for the webinar is currently open. The agenda will cover the following:

• Overview of MDPP policies finalized in the calendar year 2017 Medicare Physician Fee Schedule
• What you need to know now to prepare your organization for enrollment in Medicare as an MDPP supplier
• Question and answer session 

Additional information on the Physician Fee Schedule is available at the links below. 

Physician Fee Schedule Press Release

Physician Fee Schedule Fact Sheet

MDPP Fact Sheet