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    HHS seeks Medicare benefit for diabetes prevention program

    The Department of Health and Human Services (HHS) recently announced plans to expand its Diabetes Prevention Program, a model funded by the Affordable Care Act, now that results have shown that the program aimed at high-risk seniors not only improved health but also resulted in reduced net Medicare spending on beneficiaries.

    Provisions in the Affordable Care Act established the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation to test new service delivery models. According to the law, if a tested model is successful “the [HHS] Secretary may, through rulemaking, expand (including implementation on a nationwide basis) the duration and the scope of a model that is being tested…”

    A large study of the Diabetes Prevention was conducted through an almost $12 million grant given to the National Young Men’s Christian Association (YMCA) of the USA. Independent evaluators of the program found that participation resulted in weight loss for patients with prediabetes and a reduction in Medicare costs.

    According to HHS, the administration supports the expansion of the Diabetes Prevention Program to include all Medicare beneficiaries. This would be the first time that a preventive service model from the CMS Innovation Center would become eligible for expansion into the Medicare program.

    More information about how CMS could expand the Diabetes Prevention Program will be included in the CY 2017 Medicare Physician Fee Schedule proposed rule, which is anticipated to be released this summer, according to HHS.


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