Dietitian Course: Newest 2024 Reimbursement Rules and Waivers for the Medicare Diabetes Prevention Program Expanded Model

NEWEST 2024 REIMBURSEMENT RULES AND WAIVERS FOR THE MEDICARE DIABETES PREVENTION PROGRAM EXPANDED MODEL

This presentation is designed to enable RDNs, diabetes healthcare professionals and organizations to successfully obtain reimbursement for the Medicare Diabetes Prevention Program (MDPP) Expanded Model in 2024. CMS announced Nov 2, 2023, that it will extend the rule that allows all MDPP suppliers to use the many very specific MDPP COVID-19 Public Health Emergency (PHE) waivers/flexibilities, including the optional ALLVIRTUAL delivery of the MDPP through distance learning. The extension of the specified PHE waivers/flexibilities will run through December 31, 2027. The most current coverage guidelines and waivers 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 and the core maintenance phases in the first year (yes, there is no more 2nd year) ; beneficiary eligibility; MDPP supplier eligibility to furnish and bill for the benefit; the 6 new procedure codes (down from 15!...whew!); Lifestyle Coach requirements; the newest (2021) CDC Diabetes Prevention Recognition Program (DPRP) recognition requirements for organizations to furnish the MDPP and bill Medicare as suppliers (YES, practices that employ RDNs and diabetes educators can bill!); and the newest MDPP payment rates (much more generous than the first pay rates!). The MDPP provides opportunities for nutrition and dietetics practitioners, and diabetes care and education specialists, to play an important role in diabetes prevention in the Medicare population in health care orgs and also in non-medical community settings. Here are some somber statistics that you can help change: 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.

Upon successful completion of this two-hour course, the participant should be able to:

State the 3 levels of recognition for a Diabetes Prevention Program (DPP) from the CDC (recognition required to bill Medicare).

State who the MDPP "billing providers" can be; and the name given to those who furnish the MDPP.

State the minimum number of visits to be furnished in year 1, months 1-6 and in months 7-12.

Explain the newest 2024 MDPP reimbursement rules with regard to virtual visits/distance learning.

State how beneficiaries can now be weighed in 2024 that is not in-person.

Explain CDC's requirements for Lifestyle Coaches in the DPP and MDPP.

State the eligibility requirements for Medicare beneficiaries to start the MDPP, and how they differ from the CDC's DPP participant eligibility requirements.

Explain the CMS requirements to become a MDPP "supplier" and thus be able to bill Medicare.

Review how Medicare reimburses MDPP suppliers, and how billing codes have changed in 2024.

Live Event Date: Feb 22, 2024

Expiration Date: Feb 22, 2027

Performance Indicators/Learning Objectives: 13.3.7, 14.2.6

Target Audience: RDs, DTRs, CDCESs

Number of Credits: 2.0

Level(s): 1, 2

Total Cost: 2 Site Credits

About the Presenter: Mary Ann Hodorowicz, RD, CDCES, 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.

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