Senators Scott, Warner Lead Bipartisan Letter Urging Improved Access to Care for Diabetes Patients
Thursday, October 31st, 2019
Senators Tim Scott (R-SC) and Mark Warner (D-VA) led a bipartisan letter to Department of Health and Human Services (HHS) Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, urging them to make CDC-recognized virtual Diabetes Prevention Program (DPP) providers eligible for reimbursement in the Medicare Diabetes Prevention Program (MDPP) expanded model.
The total direct and indirect costs of diabetes in the United States is estimated to be $245 billion, and by some estimates, CMS spends one in every three dollars caring for beneficiaries with diabetes. For many, access to the MDPP program is limited due to geographical location, and enrollment numbers have been significantly below initial expectations. The Department of Health and Human Services initially expected to include as many as 110,000 individuals in the program, but it only enrolled 200 patients in 2018. This has also resulted in reduced savings from initial projected savings of $182 million from 2018-2027.
Including virtual providers would empower beneficiaries, regardless of their zip code, with feasible options for preventative, value-based care. In addition, including virtual DPP providers in the expanded MDPP and embracing digital health tools to empower patients would deliver better health outcomes and drive additional savings across the healthcare system.
“A Medicare beneficiary’s access to this life-improving program should not, and cannot, be determined solely by the zip code in which he or she lives. Furthermore, lack of access for eligible beneficiaries has the potential to not only depress enrollment, but also to reduce potential cost savings. CMS has done outstanding work developing online resources to show where MDPP suppliers are located, but these resources make clear that there are geographic regions where eligible beneficiaries lack reasonable access to a qualified supplier. Including virtual providers could empower these beneficiaries with feasible options for preventive, value-based care…”
“Virtual delivery of MDPP has the ability to empower beneficiaries to access MDPP regardless of where they live, and in the format of their choosing. Because of the outcome-focused reimbursement structure, CMS is insulated from reimbursing for ineffective treatment. Medicare Advantage plans have also been vocal in their desire to deploy virtual DPP for their beneficiaries. Given this, we also encourage CMS to consider ways for Medicare Advantage plans to use virtual providers to ensure that all Medicare beneficiaries have access to a CDC fully-recognized DPP…”
Senators Scott and Warner were joined on the letter by Senators Kevin Cramer (R-ND), Jacky Rosen (D-NV), Shelley Moore Capito (R-WV), Jeanne Shaheen (D-NH), Marsha Blackburn (R-TN), Tina Smith (D-MN), Cindy Hyde-Smith (R-MS), Kyrsten Sinema (D-AZ), Martha McSally (R-AZ), Debbie Stabenow (D-MI), Roger Wicker (R-MS), Mazie Hirono (D-HI), Mike Rounds (R-SD), Brian Schatz (D-HI), Susan Collins (R-ME), Gary Peters (D-MI) and Joni Ernst (R-IA).