Advocacy Victory: HHS Proposes Medicare Coverage for NDPP

The Secretary of the Department Health and Human Services (HHS), Sylvia Burwell, announced today that the Centers for Medicare and Medicaid Services (CMS) plans to provide coverage for the National Diabetes Prevention Program (NDPP). While this proposal still must go through a public comment period, it is expected to go into force before President Obama leaves office. This is a major victory for the Society and for the broader diabetes community.

The NDPP is an evidence-based lifestyle intervention program that has been shown to reduce or delay the onset of diabetes by 71% in the Medicare population. NDPP promotes weight loss and encourages increased physical activity and healthier eating habits for people with prediabetes via a core 16-session lifestyle intervention: one hour a week, in a group setting, directed by a lifestyle coach. Studies show that Medicare saved $2,650 for each individual who was enrolled in a program, as individuals were able to substantially reduce their risk for future diabetes.

Over the past five years, the Endocrine Society has been a leading advocate calling for Medicare coverage of NDPP. We met with both Congressional offices and federal agencies and we worked with other diabetes advocates to share our message. We are pleased with HHS’ decision to provide coverage and look forward to working with the agency and with coalition partners to ensure that this program has a measurable impact on the lives of people with prediabetes. It is not yet clear how Medicare will reimburse for these services, as it will be delineated in future rulemaking; the Society will provide comments to CMS on this issue and will inform its members as we move forward in ensuring that people with prediabetes have access to these programs.

The proposed expansion in Medicare coverage was made possible by provisions in the Affordable Care Act. Today, the Endocrine Society is releasing policy recommendations to improve care for people with diabetes as the government continues to implement the healthcare law. To learn more about ways you can get involved in the Society’s diabetes advocacy activities, contact Meredith Dyer.

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