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Medicare proposes rules for tele health delivery of DPP during Covid-19 emergency

The Medicare Diabetes Prevention Program (MDPP) expanded model aims to prevent progression to type 2 diabetes in individuals with prediabetes. The services furnished under the MDPP expanded model are currently required to be delivered in-person, except for limited virtual make-up sessions. In the wake of Covid-19 many organizations providing in-person Medicare Diabetes Prevention Programs were forced to stop their classes to comply with the social distancing regulations. Centers for Medicare and Medicaid Services proposed changes for MDPP in 2021 physician fee schedule. It is proposing to revise certain MDPP policies during the remainder of the COVID-19 Public Health Emergency (PHE) and any future applicable 1135 waiver event triggered during national emergency. CMS proposes to determine whether safe delivery of MDPP in-person classes are possible during the PHE. CMS is proposing the following amendments to the original rule during the Covid-19 PHE

  1. Virtual sessions: Suppliers can provide as many virtual sessions as needed that are consistent with the CDC Diabetes DPRP standards for virtual sessions, follow the CDC-approved DPP curriculum requirements, and the supplier has an in-person DPRP organizational code. CMS proposes to amend the regulations to clarify that all sessions, including the first core session, may be offered virtually, not as “virtual make-up sessions. This modification is temporary and in-person MDPP classes will resume after the PHE.

  2. Obtaining weight measurements: CMS proposes that the MDPP suppliers may obtain weight measurements through the following methods: (1) in-person, when the weight measurement can be obtained safely and in compliance with any and all applicable laws and regulations; (2) via digital technology, such as scales that transmit weights securely via wireless or cellular transmission (commonly referred to as “Bluetooth™ enabled”); or (3) self-reported weight measurements from a participant’s own at-home digital scale. Self-reported weights must be submitted via video, by the MDPP beneficiary to the MDPP supplier.

  3. Weight loss requirements: Effective January 1, 2021, all MDPP beneficiaries would be required to achieve and maintain the required 5 percent weight loss goal in order to be eligible for the ongoing maintenance sessions.

  4. Engagement incentive period: CMS proposes that the engagement incentive period end when the MDPP supplier has not had direct contact, either in person by telephone, or via other telecommunications technology, with the MDPP beneficiary for more than 90 consecutive calendar days during the MDPP services period (unless the lack of direct contact is due to the suspension or cancellation of MDPP services and the MDPP services are eventually resumed or restarted)

August 18, 2020

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