Hoping to boost enrollment in the struggling Medicare Diabetes Prevention Program (MDPP) expanded model, CMS has proposed changes that would increase reimbursement and significantly shorten the services period for participants. While stakeholders agree that the changes are needed, some warn they’re only incremental steps to shore up the MDPP, which has faced a shortage of suppliers and challenges posed by the requirement that the program be delivered to beneficiaries in person.

“The MDPP rules and regulations, including the payment mechanism and the two-year commitment — in contrast to one year for the CDC DPP [U.S. Centers for Disease Control and Prevention Diabetes Prevention Program] — have made enrollment very difficult if not impossible for MDPP suppliers,” asserts Liz Joy, M.D., senior medical director for wellness and nutrition at Intermountain Healthcare.

“The CMS regulations reduced the number of DPPs that could become MDPP suppliers, thereby limiting access for Medicare Advantage members,” Joy tells AIS Health, a division of MMIT. “Additionally, CMS did not allow the virtual DPPs to become suppliers, so for MA members who live in more rural areas, access is even more limited.”

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