Cms-r-247

CMS Response to Public Comments Received for CMS-R-247

The Centers for Medicare and Medicaid Services (CMS) received two comments from Novo Nordisk Inc related to CMS-R-247. Below is a summary of the comments and our responses.

Comment:

Access to diabetes outpatient self-management must be improved. CMS should undertake to review the current barriers to accessing this important benefit and make changes that can dramatically improve access.

Response:

CMS appreciates the suggestions and concern expressed by this commenter. The barriers to accessing diabetes self-management training (DSMT) and removing those barriers is outside the scope of this PRA collection. However, CMS will continue to work with the diabetes community to ensure access to this benefit.

Comment:

Reimbursement for diabetes outpatient self-management training should be reviewed and increased. Currently, Medicare payment rates for individual and group diabetes self-management training (DSMT) are low, with individual DSMT receiving $31.83 per 30 minutes and group DSMT receiving $18.57 per 30 minutes. The commenter is extremely concerned with this level of payment for DSMT services. It is vital that beneficiaries with diabetes have full access to the education they need to manage their illness; the low payment rates for DSMT could serve as a barrier to access. We ask that CMS take steps to increase payment for DSMT as part of the agency’s overall commitment to improving care and outcomes for Medicare beneficiaries with diabetes.

Response:

CMS appreciates the suggestion and concern expressed by the commenter regarding the need to modify the Medicare payment rates for individual and group diabetes self-management training (DSMT) to increase access to education to manage their diabetes. The changes the commenter advocates are outside the scope of this PRA submission.