2018 Proposed Physician Fee Schedule Released

​Medicare Expansion of Diabetes Prevention Program (DPP) Model

The Medicare Diabetes Prevention Program (MDPP) expanded model is a structured intervention with the goal of preventing or delaying type 2 diabetes in individuals with prediabetes. The MDPP expanded model will allow Medicare beneficiaries to receive an evidence-based diabetes prevention program, with the goal of a lower rate of progression to type 2 diabetes, improved health and reduced costs.

The program consists of a minimum of 16 intensive “core” sessions delivered over six months in a group-based, classroom-style setting that provides practical training in long-term dietary change, increased physical activity, and behavior change strategies for weight control. After completing the core sessions, follow-up meetings are delivered monthly. The primary goal of the expanded model is at least 5 percent weight loss by participants.

AADE is pleased to see Medicare’s continued focus on ensuring the National Diabetes Prevention Program (National DPP) will be a reimbursable. We now know that supplier enrollment to become a MDPP supplier will be effective on January 1, 2018 and the furnishing of MDPP services within the expanded model will begin April 1, 2018. AADE is currently preparing services to assist programs through the process of CDC Recognition and DPP implementation as well as CMS application to become an MDPP Supplier.

The final rule appeared in the November 2017 Federal Register which finalizes policies to implement the Medicare Diabetes Prevention Program (MDPP) expanded model.

Diabetes Prevention – A Covered Benefit

Last year, CMS announced the National Diabetes Prevention Program (National DPP) would be a covered benefit beginning in 2018. CMS received hundreds of comments, from both AADE and diabetes educators like you, regarding coverage of the National DPP, and took many of these into consideration when establishing the final rule. 

AADE Prevention Network

In 2017, AADE launched the AADE Prevention Network, taking tools that were being used by current programs operating within AADE’s in-person diabetes prevention delivery network, and making them available to any organization that is DPRP recognized and wanting to prepare for the MDPP benefit. Based on the 2018 Physician Fee Schedule and CMS’s final ruling, we will continue to offer tools, resources, education and support along the way to assist programs in the delivery of the National DPP.