Senate Examines Diabetes Coverage

Congress should consider changing Medicare eligibility requirements to permit diabetes self-management training (DSMT) for individuals at risk of developing the disease, according to a new paper published by a work group of the Senate Finance Committee. Currently Medicare Part B DSMT coverage is available for individuals with diabetes but not for those at risk of diabetes (“prediabetes”). Trainings include glucose blood level self-monitoring, instruction on proper diet and exercise regimens, individualized insulin treatment planning, medication management and motivational counseling. The workgroup proposes consideration of Part B coverage for individuals at risk of developing the disease, using criteria that would be established by the Centers for Disease Control and Prevention. The work group is also discussing whether to permit service delivery by non-profits and health departments—Quality Improvement Organizations like IPRO’s Atlantic Quality Innovation Network are currently providing DSMT services under a Medicare-funded, five-year workplan that began in August 2014. The workgroup proposal is one of a series of recommendations included in a 30-page draft on chronic care innovation released December 18. Comments will be accepted through January 26. For more information, visit the Committee’s website at www.finance.senate.gov.