Medicare reimbursement and diabetes self-management training: national survey results

The AADE and ADA are committed to using these survey results to address the issues identified concerning Medicare reimbursement of diabetes self-management training programs. As a result, the following Web-based conferences have been conducted: Reimbursement Update 2003 (ADA) and Achieving and Maintaining Education Program Recognition (ADA). There were many registrants for these conferences, and their positive evaluations indicated that online continuing education programs were well received. Multiple education opportunities continue to be provided at local and national meetings. For example, programs were presented at the ADA Southern Regional Conference in May and the AADE Annual Meeting in August 2004. In addition, the AADE Annual Meeting offered workshops on reimbursement issues, including one conducted by a director from the CMS. An excellent desktop reference for questions regarding reimbursement is the manual, The Guide to Reimbursement. Organizations need to maintain strong volunteer and organization commitment to assure that DSMT is not only valued but also compensated for services rendered. The AADE and ADA volunteers continue to join together to advocate for adequate reimbursement for DSMT. To accomplish this goal, all affected organizations need to continue to partner and seek funding to promote legislative activities and education of health professionals regarding reimbursement and billing processes. Today diabetes education is revered as integral to diabetes care and management. The results gained from this national survey are a platform for enhancing the fiscal viability of the programs that provide this service. The survey data suggest that professionals need ongoing education on the fiscal considerations regarding DSMT programs, including the need for accurate documentation, awareness of current reimbursement status, processes for monitoring billing and appealing claims, establishing working relationships with billing services, implementing the use of advanced beneficiary notice, and the significance of establishing a financial reporting system specific for DSMT. Our mission is clear--"Diabetes is the essence of our work; reimbursement is the essence of our continued existence."