Medicare Diabetes Prevention Program
MEDICARE DIABETES PREVENTION PROGRAM MODEL EXPANSION: OVERVIEW OF FINAL RULE IN CY 2018
This jammed-packed and detailed presentation is exactly what diabetes healthcare professionals and organizations need to successfully obtain reimbursement for the brand new Medicare Diabetes Prevention Program (MDPP) benefit, starting April 1, 2018. The most current coverage guidelines are outlined....in a very straightforward and easy-to-understand manner...with special emphasis on those that create the most confusion: the required structure of the MDPP in the core, core maintenance and on-going maintenance intervals in the first and second years; beneficiary entitlement and lab eligibility; supplier eligibility to furnish and bill for the benefit; lifestyle coach requirements; the 15 new "bundled" procedure codes; the CDC Diabetes Prevention Recognition Program (DPRP) requirements and the new CMS Interim Recognition requirements for organizations to enroll in Medicare as MDPP suppliers; and the MDPP payment rates. Organizations who are offer the MDPP now are allowed to enroll in Medicare Part B, effective 1-1-18 (if select criteria are met), so now is the right time to attend this webinar!

BACKGROUND INFORMATION:

The National Diabetes Prevention Program (National DPP) has shown an impressive 4.2% mean weight loss achievement in a large-scale study. CMS projects that the brand new Medicare DPP (MDPP) Expanded Model will save $182 million over 10 years. Beginning April 1, 2018 Medicare beneficiaries with prediabetes who also have elevated BMI and a lab value validating a diagnosis of prediabetes will have a new benefit with coverage for diabetes prevention services. The coverage is for 1 year of in-person structured health behavior change group sessions that use an approved curriculum from the Centers for Disease Control and Prevention (CDC). For Medicare reimbursement to the sponsoring organization of the MDPP (supplier), the services can only be provided by approved Medicare suppliers. Supplier enrollment began on 1-1-18 to allow time for programs to complete the application process and prepare for providing reimbursable services to beneficiaries on or after 4-1-18. The MDPP provides opportunities for nutrition and dietetics practitioners, and diabetes educators, to play an important role in diabetes prevention in the Medicare population in health care and also non-medical community settings.

This very detailed webinar will review in detail:


  • The Medicare requirements for billing for the MDPP benefit. Medicare will be using an Alternative Payment Model that is performance-based payment for the MDPP services. There are 15 new "G" procedures codes for the MDPP, as well as attendance and weight loss requirements to earn maximum payments from CMS.


  • Types of CDC DPRP recognition and requirements for each, and requirements for Lifestyle Coaches (recognition is required for an organization to enroll in Medicare as a MDPP supplier).


  • The new "Interim Preliminary Recognition" by CMS (until the 2018 CDC DPRP Standards and Operating Procedures are effective).
Upon successful completion of this two-hour course, the participant should be able to:

  1. Describe the methods of entry for beneficiaries into the MDPP (including clinical criteria).
  2. Describe who can be MDPP "suppliers" and the Medicare supplier requirements.
  3. Describe the CDC Diabetes Prevention Recognition Program (DPRP) requirements for organizations to enroll in Medicare as MDPP suppliers.
  4. State how many MDPP visits that Medicare will pay for in total.
  5. State the beneficiary eligibility criteria for coverage of the MDPP.
  6. Explain the beneficiary eligibility criteria for the maintenance monthly sessions in the 2nd 6 months of the 1st year.
  7. Explain the beneficiary eligibility criteria for the on-going maintenance monthly sessions in the 2nd year.
  8. Describe the Medicare MDPP Lifestyle Coach requirements (for Medicare enrollment and screening of coaches).
  9. State the 3 types of DPP recognition granted to DPPs by the CDC in its 2015 DPRP Standards and Operating Procedures.


FOR CDEs: This Course Qualifies for CE Credit!

To satisfy the requirement for renewal of certification according to the National Certification Board for Diabetes Educators (NCBDE, www.ncbde.org), courses must relate to diabetes and be part of the list of recognized providers of the NCBDE. The Commission on Dietetic Registration (CDR) is listed as an NCBDE recognized provider. Because Dietitian Central has been granted accreditation by the CDR, it therefore meets the criteria as an approved provider of CEs for CDEs by the NCBDE. The NCBDE does not directly approve continuing education for any specific webinar or self study course.

Live Event Date: Mar 29, 2018
Learning Need Codes (LNC): 7170, 7130, 5190
Performance Indicators/Learning Objectives: 13.3.7, 14.2.6
Target Audience: RDs, DTRs, CDEs
Number of Credits: 2.0
Level(s): 1, 2
Total Cost: $36 ($18.00 per credit)

About the Presenter: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Mary Ann Hodorowicz, RDN, CDE, MBA, Certified Endocrinology Coder owns a corporate consulting practice in Palos Heights, IL, (Mary Ann Hodorowicz Consulting, LLC) that specializes in customized consulting, training, writing and professional presentation services for the healthcare and food industry in these areas:

  • Diabetes Self-Management Education/Training (DSME/T).
  • Medical Nutrition Therapy (MNT).
  • Medicare Diabetes Prevention Program (MDPP).
  • Medicare Intensive Behavior Therapy for Obesity Benefit.
  • Diabetes Care Services: Shared Medical Appointments, CGM, CSII, SMBG, Remote Patient Monitoring, Chronic Care Management, Insulin Titration, etc..
  • Medicare and Private Payer Insurance Reimbursement for above.
  • Medicare Quality Payment Plan and Merit-based Incentive Payment System (MIPS) For RDNs.
  • Business Plans (Clinical, Marketing, Operational, Financial and CQI components).
  • Evidence-Based Standards of Diabetes Care.
  • Achieving AADE Accreditation or ADA Recognition for DSME/T Programs (requirements and comprehensive turn-key materials, including Policy and Procedure Manual).
  • E.M.A. Tools for Successful Behavior Change: Motivational Interviewing, Patient Empowerment and Adult Learning Tools.
  • For Providers Only: Risk Adjustment Payment Methodologies Used by CMS and Select Private Healthcare Insurers.
Mary Ann Hodorowicz is a nationally recognized registered dietitian/nutritionist (RDN), certified diabetes educator (CDE) and certified endocrinology coder (CEC) with a MBA degree (marketing focus). She applies nearly forty years of experience in her work as a consultant, writer, speaker and trainer within her business Mary Ann Hodorowicz Consulting, LLC. Mary Ann is known for her expertise in multiple diabetes care and medical nutrition therapy (MNT) areas; see bulleted list above.

She is especially known for her knowledge on insurance reimbursement, coding and coverage guidelines for diabetes care and MNT interventions. Her clients are in the health, food, pharmaceutical and insurance industries, and include CMS, the CDC, AADE, and multiple state and local departments of public health. Mary Ann has given over 600 presentations, webinars and live training engagements, at which she generously shares her wide array of practice resources. She has written numerous articles in peer-reviewed journals, authored continuing education online modules for AADE, and is a contributing or lead author for multiple toolkits, fact sheets and 'how-to' guides for nutrition and diabetes care professionals on the subjects of insurance reimbursement and creating effective business plans for the sustainability of their services. She served on the AADE Board of Directors from 2013 - 2015.

Other Webinars by this Presenter/Organization:

Clinical and Teaching Plan for a Best Practice MNT and DSMES Program: Proven Keys to Sustainability

On Demand
Live Date: (Apr 11,2019)
Expiration Date: (Apr 10,2022)

Rating: 4.78 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

MNT-DSMES Program

Financial Plan for a Best Practice MNT-DSMES Program

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Live Date: (Mar 14,2019)
Expiration Date: (Mar 13,2022)

Rating: 4.83 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

MNT and DSMT Reimbursement

Money Matters in MNT and DSMT: Increase Your Reimbursement Now

On Demand
Live Date: (Feb 28,2019)
Expiration Date: (Feb 27,2022)

Rating: 4.85 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

Giving Dynamite Presentations

Dietitian's Complete Guide to Giving Dynamite Presentations that Ignite Passion and Action

On Demand
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Expiration Date: (Jul 18,2021)

Rating: 4.53 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

Nutrition Health Insurers

Overview of Health Insurers' Nutrition, DSMES and Related Benefits and 10 Steps to Optimize Billing, Coding and Reimbursement

On Demand
Live Date: (Jun 07,2018)
Expiration Date: (Jun 06,2021)

Rating: 4.75 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

DSME Program

How to Build the BUSINESS CASE for a DSME Program

On Demand
Live Date: (Jul 28,2017)
Expiration Date: (Jul 27,2020)

Rating: 4.78 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

Medicare Reimbursement

Medicare Reimbursement Billing and Coding for Intensive Behavior Therapy for Obesity

On Demand
Live Date: (Jul 11,2017)
Expiration Date: (Jul 10,2020)

Rating: 4.57 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

MNT for Adults with Diabetes

Evidence-Based Nutrition Practice Guidelines to Control the A-B-Cs of Type 1 and Type 2 Diabetes in Adults

On Demand
Live Date: (May 18,2017)
Expiration Date: (May 17,2020)

Rating: 4.78 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

Diabetes Medications

Diabetes Medication Update: The Tried, The True and The New

On Demand
Live Date: (Mar 21,2017)
Expiration Date: (Mar 20,2020)

Rating: 4.75 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

CQI Plan

Step by Step Continuous Quality Improvement Plan for DSME, MNT and Weight Management Programs

On Demand
Live Date: (Oct 25,2016)
Expiration Date: (Oct 24,2019)

Rating: 4.50 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours

ema interviewing

E.M.A. Tools for Successful Behavior Change: Empowerment, Motivational Interviewing and Adult Learning

On Demand
Live Date: (Aug 30,2016)
Expiration Date: (Aug 29,2019)

Rating: 4.63 out of 5

Instructor: Mary Ann Hodorowicz, RD, CDE, MBA, Certified Endocrinology Coder

Duration: 2 hours