We are sure you have heard about the recent decision by the Centers for Medicare and Medicaid Services (CMS) concerning coverage for Intensive Behavioral Counseling for Obesity. While CMS’ decision was expected, the announcement has drawn the attention of ADA, registered dietitians and health care advocates across the country and rightfully so. In this email, we would like to review ADA’s involvement in the process that led to CMS’ decision, update you on the opportunities this decision creates for us; and detail our Association’s next steps – including what every individual member can do to expand our ability to provide reimbursed MNT services under Medicare. Are you ready to take action? We say, let’s own this thing!…

See full letter sent to all members

Sylvia A. Escott-Stump, MA, RD, LDN 2011-2012 President American Dietetic Association Patricia M. Babjak Chief Executive Officer American Dietetic Association

Medical Nutrition Therapy improves patient outcomes, quality of life and lowers health-care costs. Medicare covers outpatient MNT provided by registered dietitians for beneficiaries with diabetes, chronic renal insufficiency/end-stage renal disease (non-dialysis renal disease) or post kidney transplant. Many other private insurance companies also cover MNT services for a variety of conditions and diseases (see below).

MNT includes nutritional diagnostic, therapeutic and counseling services for the purpose of disease management. Qualifying patients generally receive three hours of MNT in the first year and two hours of MNT in subsequent years. For changes in medical diagnosis, condition or treatment, Medicare covers additional hours of MNT.

The following are a few easy steps to ensure patients are eligible to receive MNT:

1.          Medicare requires a physician order for patients to see an RD for MNT. When making a referral the physician should be sure to:

• Include the diagnosis and diagnosis code(s) for diabetes or non-dialysis kidney disease.
• Send recent lab data and medications with the referral form.
• Document the medical necessity for MNT in the patient’s medical chart.

2.          The nurse should make an appointment with an RD at a local hospital out-patient clinic, physician clinic or the registered dietitian’s private practice office.

3.          When additional hours of MNT are needed for your patient, another referral and medical record documentation are needed.

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