Support the Diabetes Educator's Bill

classicdame, MSN, EdD · May 18, 2009

There has got to be more to this than what AADE has on their site. Medicare currently pays for DSMT, but only once every few years. What else is AADE supporting in this bill?

country mom · May 19, 2009

Congressional Legislation

Improve access to Diabetes Self-Management Training

Bill # H.R.2425

Original Sponsor:

Diana DeGette (D-CO 1st)

Cosponsor Total: 5

(last sponsor added 05/14/2009)

3 Democrats

2 Republicans

About This Legislation:

To amend title XVIII of the Social Security Act to improve access to diabetes self-management training by designating certain certified diabetes educators as certified providers for purposes of outpatient diabetes self-management training services under part B of the Medicare Program.

Detailed, up-to-date bill status information on H.R.2425

Currently, Certified Diabetes Educators (CDE's) are not recognized as providers by CMS (unless the CDE is also a Registered Dietitian). This means that CDE's must be tied to a hospital or clinic and bill through the agency. Hospitals and clinics are closing their programs left and right, mostly for financial reasons, it's just so difficult to maintain a profitable DSMT program that unless the agency is willing to keep the program open as a community service, the program is closed. This bill would recognize CDE's as providers, who then could operate independently hopefully increasing access for patients to diabetes education.

P.S. The Medicare benefit for Diabetes Education is currently 10 hours in the initial 12-month period, and 2 hours of follow-up annually.

llg, PhD, RN · May 19, 2009

So ... if this bill passes ... any CDE could set up shop anywhere (e.g. in their home) as an independent legal entity and get reimbursed by Medicare?

Educate me, please. Who would be regulating their practice, accrediting, etc.? Are those mechanisms already in place for CDE's practicing independently without being affilitated with a hospital, agency, etc.? What accreditation agency (or whatever) would such independent educators fall under?

classicdame, MSN, EdD · May 19, 2009

Another thing, if the CDE can operate a DSMT program at profit, why can't the hospital?

Myxel67 · May 20, 2009

Medicare still provides coverage as you stated, but unfortunately Medicaid stopped covering DM education over 2 years ago--and that's a shame. :bluecry1:

country mom · May 21, 2009

Medicare still provides coverage as you stated, but unfortunately Medicaid stopped covering DM education over 2 years ago--and that's a shame.

Medicaid still covers DSMT (Diabetes Self-Management Training) in some states, but as you have stated, that is not the case everywhere. You're right, it is a shame, especially when the highest-risk individuals are blocked from access.

country mom · May 21, 2009

So ... if this bill passes ... any CDE could set up shop anywhere (e.g. in their home) as an independent legal entity and get reimbursed by Medicare?
Educate me, please. Who would be regulating their practice, accrediting, etc.? Are those mechanisms already in place for CDE's practicing independently without being affilitated with a hospital, agency, etc.? What accreditation agency (or whatever) would such independent educators fall under?

Currently, the American Diabetes Association and the American Association of Diabetes Educators are the two accrediting bodies accepted by CMS to recognize diabetes education programs. A diabetes education program cannot be reimbursed by medicare unless the program has undergone the recognition process and found in compliance. The standards are quite stringent and specify everything from topics that must be covered, to who must serve on the advisory board, QI process, documentation, and so forth.