CMS reminds healthcare professionals that March is National Nutrition Month® - a campaign focused on the importance of making informed food choices, and developing sound eating and physical activity habits. More than 35 percent of American men and women are obese, and adult obesity is associated with a number of serious health conditions, including heart disease, hypertension, diabetes, and some cancers.
Medicare provides coverage for the following nutrition-related health services: § Intensive Behavioral Therapy (IBT) for Obesity - Effective Tue Nov 29, 2011 o Medicare provides coverage of Intense Behavioral Therapy for Obesity for qualifying beneficiaries whose body mass index (BMI) is equal or greater than 30 kg/m2. This coverage includes Screening for obesity in adults using measurement of BMI, a Dietary (nutritional) assessment, and intensive behavioral counseling and behavioral therapy to promote sustained weight loss through high intensity interventions on diet and exercise. This coverage includes one face-to-face visit every week for the first month, one face-to-face visit every other week for months 2-6, and one face-to-face visit every month for months 7-12, if the beneficiary meets the 3kg (6.6 lbs) weight loss requirement during the first 6 months. § Intensive Behavioral Therapy for Cardiovascular Disease - Effective Tue Nov 8, 2011 o Medicare provides coverage of IBT for cardiovascular disease (referred to as a CVD risk reduction visit). The visit consists of the following three components: § Encouraging aspirin use for the primary prevention of cardiovascular disease when the benefits outweigh the risks for men age 45-79 years and women 55-79 years; § Screening for high blood pressure in adults age 18 years and older; and § Intensive behavioral counseling to promote a healthy diet for adults with hyperlipidemia, hypertension, advancing age, and other known risk factors for cardiovascular and diet-related chronic disease. § Medical Nutrition Therapy (MNT) o Medicare provides coverage of MNT for certain beneficiaries diagnosed with diabetes and/or renal disease*, when referred by the treating physician and provided by a registered dietitian or nutrition professional. § Diabetes Self-Management Training (DSMT) o Medicare provides coverage of DSMT services for beneficiaries who have been diagnosed with diabetes. DSMT services are intended to educate beneficiaries in the successful self-management of diabetes. A qualified DSMT program includes among other services education about nutrition, diet, and exercise. § Annual Wellness Visit o The Annual Wellness Visit presents an opportunity for health professionals to provide eligible beneficiaries with personalized health advice and referrals, as appropriate, to health education, preventive counseling services, and community-based lifestyle interventions, focusing on reducing health risks and promoting self-management and wellness, including weight loss, physical activity, smoking cessation, fall prevention, and nutrition. What Can You Do? You can help your Medicare patients live healthier lives in 2012 by encouraging the use of the above Medicare-covered services. These services present excellent opportunities to begin a dialogue with your Medicare patients about their dietary habits and how their eating habits may affect their health, and make recommendations for preventive services that can help them reach their nutritional and dietary goals. Remember to provide any appropriate written referrals. More Information for Healthcare Professionals: § MLN Guide to Medicare Preventive Services<http://www.cms.gov/MLNProducts/downloads/mps_guide_web-061305.pdf> (see Chapter 6) § MLN Diabetes-Related Services factsheet<http://www.cms.gov/MLNProducts/downloads/DiabetesSvcs.pdf> § National Coverage Determination (NCD) for Medical Nutrition Therapy<https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=252&ncdver=1&NCAId=53&NcaName=Medical+Nutrition+Therapy+Benefit+for+Diabetes+%26+ESRD&IsPopup=y&bc=AAAAAAAAIAAA&;> § National Diabetes Education Program<http://ndep.nih.gov/> § National Nutrition Month website<http://www.eatright.org/nnm/> § Nutrition Education Resources<http://www.eatright.org/NNM/content.aspx?id=5342> § Million Hearts(tm) campaign website<http://millionhearts.hhs.gov/> * Note that, for the purpose of this benefit, renal disease means chronic renal insufficiency or the medical condition of a beneficiary who has been discharged from the hospital after a successful renal transplant for up to 36 months post transplant. Chronic renal insufficiency means a reduction in renal function not severe enough to require dialysis or transplantation [Glomerular Filtration Rate (GFR) 13-50 ml/min/1.73m2]. ________________________________ It's Not too Late to Give and Get the Flu Vaccine. Take advantage of each office visit and protect your patients against the seasonal flu. Medicare will continue to pay for the seasonal flu vaccine and its administration for all Medicare beneficiaries through the entire flu season. The Centers for Disease Control and Prevention (CDC) also recommends that patients, healthcare workers and caregivers be vaccinated against the seasonal flu. Protect your patients. Protect your family. Protect yourself. Get the Flu Vaccine-Not the Flu. Remember - The flu vaccine plus its administration are covered Part B benefits. CMS has posted the 2011-2012 seasonal flu vaccine payment limits at http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp. Note that the flu vaccine is NOT a Part D-covered drug. For more information on coverage and billing of the flu vaccine and its administration, as well as related educational provider resources, visit http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and http://www.cms.gov/immunizations. ________________________________ Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. 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