In CMS’s 2022 Physician Fee Schedule (PFS) final rule, the agency finalized changes intended to boost MDPP Supplier Enrollment and Medicare beneficiary participation in the MDPP. On November 2, 2017, CMS issued the CY 2018 PFS final rule, which established policies related to the set of MDPP services, including beneficiary eligibility criteria, the MDPP payment structure, and supplier enrollment requirements and compliance standards aimed to enhance program integrity. The final rule establishing the expansion was finalized in the Calendar Year (CY) 2017 Medicare Physician Fee Schedule (PFS) final rule published in November 2016. The Medicare Diabetes Prevention Program (MDPP) expanded model is a structured behavior change intervention that aims to prevent the onset of type 2 diabetes among Medicare beneficiaries with an indication of prediabetes. This model is an expansion of the Diabetes Prevention Program (DPP) model test, which was tested through the Center for Medicare and Medicaid Innovation’s Health Care Innovation Awards. We estimate that Medicare spent $42 billion more in the single year of 2016 on beneficiaries with diabetes than it would have spent if those beneficiaries did not have diabetes per-beneficiary, Medicare spent an estimated $1,500 more on Part D prescription drugs, $3,100 more for hospital and facility services, and $2,700 more in physician and other clinical services for those with diabetes than those without diabetes (estimates based on fee-for-service, non-dual eligible, over age 65 beneficiaries).įortunately, type 2 diabetes can usually be delayed or prevented with health behavior changes. adults (ages 18-79) by 2050 if current trends continue.
Diabetes affects more than 25 percent of Americans aged 65 or older, and its prevalence is projected to increase approximately two-fold for all U.S.