Senators, AMA urge CMS to expand diabetes programs

November 5, 2019

The AMA and a group of 19 U.S. Senators want to expand the reach of the Medicare Diabetes Prevention Program.

A bipartisan group of U.S. Senators and the American Medical Association (AMA) are seeking an expansion of the Centers of Medicare & Medicaid Services (CMS) Medicare Diabetes Prevention Program (MDPP) to include virtual diabetes prevention programs (DPPs).

MDPP was launched in April 2018 by the U.S. Department of Health and Human Services (HHS) and CMS, but it currently does not cover virtual DPPs recognized by the Centers for Disease Control and Prevention (CDC).

The 19 senators signed an October 30 letter urging HHS Secretary Alex M. Azar II and CMS Administrator Seema Verma to include virtual DPPs in the program. That would, according to the senators, make the program “scale more effectively, reaching a larger percentage of the clinically eligible population and providing even greater savings for the Medicare program.”

“A Medicare beneficiary’s access to this life-improving program should not, and cannot, be determined solely by the zip code in which he or she lives,” the letter says. “Furthermore, lack of access for eligible beneficiaries has the potential to not only depress enrollment, but also to reduce potential cost savings.”

MDPP currently provides a qualified, covered patient with a series of in-person sessions seeking to lower their risk of developing type 2 diabetes at no cost, according to medicare.gov.

The AMA has been pushing for the inclusion of these virtual DPPs since at least May 2018 in a letter citing Medicare’s expenses when it comes to services related to diabetes and prediabetes.

“Medicare spending on services related to prediabetes and diabetes is projected to cost more

than $2 trillion over the next 10 years, including $1.7 trillion in federal spending,” AMA’s May 2018 letter to CMS says. “Preventing or delaying the onset of type 2 diabetes must be a national priority as the disease is costly and places patients at high risk for severe complications and chronic diseases.”

Patrice A. Harris, MD, president of the AMA, applauded the senators’ efforts and touted the need for the MDPP to be expanded in a statement.

“We recognize that scaling an ambitious new model takes time,” she says. “Early returns suggest that a few changes would expand the program’s reach. Allowing Medicare patients to virtually access this program, as many patients with private insurance are doing, would benefit the most underserved and vulnerable patients, as well as those in remote areas, who cannot access the program without this option. Here is an opportunity for Medicare to encourage a practical use of digital health tools.”

x