Earlier this month, Kentucky passed a bill in both their House and Senate that requires a license to practice diabetes education. Governor Steve Beshear signed it into law on March 16, 2011. We are thrilled with this development and we appreciate the work our Kentucky-based educators have done to advocate on behalf of this effort.

In 2010, AADE launched a state licensure initiative, focusing our initial efforts on Kentucky, and this is our first major success.

State licensure ensures that all healthcare providers who deliver diabetes education will have sufficient knowledge to provide safe, effective care to persons with or at risk for diabetes. In addition, it increases recognition for the profession and reinforces the highest standards of care.

State licensure also accomplishes another goal that is central to the expansion of the profession. In effect, it creates a “legal” definition for a diabetes educator, and will establish a codified scope of practice. Without this legal definition, payors may reimburse for the diabetes education service (DSMT), but they may not recognize (reimburse) the provider of these services – the professionally qualified diabetes educator.

State licensure would smooth the way for the Centers for Medicare and Medicaid Services (CMS) to recognize diabetes educators as providers of DSMT at the national level, which is another major advocacy initiative for AADE. Our advocacy initiatives at the national and the state levels work together to accomplish our goals of increased reimbursement and recognition.

At this time, the CDE® is not a recognized Medicare provider. Even though healthcare professionals have to be licensed in their respective fields to be eligible to sit for the CDE exam, it is a voluntary credential and is not required for the practice of diabetes education. Any healthcare professional (with or without a license in their respective field) can now practice diabetes education.

The MD, DPM, NP, RD and PharmD are able to bill CMS because they have provider status and hold state licenses. State licensure would further open the door for certified diabetes educators to become recognized Medicare providers.

Diabetes educator licensure is intended for the health care professional who has a defined role as a diabetes educator, not for those who may perform some diabetes-related functions as part of or in the course of other routine occupational duties.

The practice documents that AADE has created (The Guidelines for the Practice of Diabetes Education, the Competencies for Diabetes Educators, the Diabetes Education Patient Curriculum, and others) provide a strong infrastructure for the future growth and standardization of the profession and served as the basis for the Kentucky legislation.

Over the next few years, we will be expanding the state licensure initiative, so stay tuned for more news. Visit the AADE website for more information or email advocacy@aadenet.org.

In addition to the AADE legislative agenda the advocacy department monitors pertinent legislation that has some impact or relevance to the diabetes community as well as the service that diabetes educators provide.

Bills of Interest

• Whitehouse Behavioral Tech bill S. 539
• Fix HIT Act of 2011 S.643 and H.R. 1187

Votes of Impact

By votes of 14-11, the Energy and Commerce subcommittee on Health approved legislation that would (links are provided for any bills that have legislative text):

• repeal mandatory funding for grants to states for establishing insurance exchanges (H.R. 1213);
• repeal mandatory funding for school-based health center construction (H.R. 1214);
• repeal the Prevention and Public Health Fund (H.R. 1217);
• and convert funding for graduate medical education at teaching health centers from direct funding to an authorization of appropriations, meaning the program would go through the annual ppropriations process (H.R. 1216).

AADE Advocacy will continue to monitor these bills and provide updates as they move through Congress.

Updates on Legislation

The House Budget Committee Resolution bill which should be marked up the week of April 4, 2011 and should come to the House floor for vote before Easter is expected to have huge Medicaid cuts (i.e., turning some portions into a block grant, moving Medicaid patients into private insurance plans). AADE Advocacy is following this legislation closely as this House bill will set the stage for all major bills at the end of the Congressional year that impact Medicaid and Medicare.

The Accountable Care Organization (ACO) proposed regulation was released Thursday March 31, 2011. To read more on this proposed regulation please click here.

If you have any questions regarding any of the issues addressed in this section please contact James Specker, AADE Advocacy Specialist at advocacy@aadenet.org

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