On January 13, 2022, the National Clinical Care Commission (NCCC) released their long-awaited final report to Congress, entitled Leveraging Federal Programs to Prevent and Control Diabetes and Its Complications, which details evidence-based recommendations to improve and streamline federal diabetes policies related to awareness, prevention and treatment programs. The report is comprehensive and covers many policy areas including addressing social determinants of health, improving affordability and accessibility, and research and awareness. ADCES advocated for inclusion of many of the recommendations. A high-level overview of key recommendations that may be of interest to diabetes care and education specialists are highlighted below.
- Recommend creation of an Office of National Diabetes Policy
- Recommend that federal policies and programs be designed to ensure that all people at risk for and with diabetes have access to comprehensive, high-quality, and affordable health care and that no one at risk for or with diabetes who needs health care cannot get it because of cost.
- Recommend that achieving health equity be a component of all federal policies and programs that affect people at risk for and with diabetes
- Recommend increased federal support for CDC to promote awareness of prediabetes and enrollment in recognized prevention programs
- Recommend CMS coverage for hemoglobin A1c testing when used to screen for prediabetes
- Recommend that Congress promote coverage for all modalities of CDC recognized diabetes prevention programs.
- Recommend that the Medicare Diabetes Prevention Program (MDPP) be approved as a permanent covered benefit (not only a model expansion service) and that coverage of MDPP be expanded to include virtual delivery. Furthermore, the “once in a lifetime” limit on participation in the MDPP should be removed.
Diabetes Self-Management and Diabetes Treatment
- Recommend that CMS update the 2000 Medicare Quality Standards that govern diabetes self-management training (DSMT) and establish a process for ongoing review, updating, and revision, with broad input from persons and parties affected by these standards.
- Recommend the following changes in CMS regulations related to DSMT to improve access and engage more people with diabetes, which align with the Expanding Access to DSMT Act:
- Allow the initial 10 hours of DSMT to remain available beyond the first 12 months from diagnosis until fully utilized.237, 238 (These numbers relate to footnotes in the full report)
- Allow for six additional hours (instead of two hours) of DSMT, if necessary.
- Allow MNT and DSMT to be delivered on the same day.
- Eliminate copays and deductibles (cost sharing) for DSMT.
- Expand the types of providers who can refer for DSMT (for example, podiatrists, specialists treating diabetes-related complications, and emergency medicine physicians).
- Recommend funding the Special Diabetes Program in five-year increments
- Recommendations around expanding Virtual Care/Telehealth
- Recommend CMS establish a process to regularly review eligibility requirements for diabetes device leading to appropriate coverage determinations
- Recommends that federal policies and programs remove cost barriers to ensure that insulin is affordable for all people with diabetes and that no one with diabetes who needs insulin cannot get it because of cost.
The NCCC, established by law and comprised of 23 federal and non-federal members, was charged with evaluating all federal programs related to diabetes and prediabetes and making recommendations to Congress to improve coordination of such programs. The NCCC has conducted activities since 2018, which culminated in the release of this final report.
ADCES has closely followed the NCCC’s meetings and activities and regularly engaged with the NCCC through the submission of written comments, discussions with NCCC subcommittees, participation in public meetings, the delivery of oral comments during these meetings, and responding to requests for information. ADCES, in collaboration with other partner organizations and coalitions, will advocate that Congress and the federal agencies implement the recommendations included in the final report, especially the recommendations related to improving access to diabetes prevention and diabetes self-management education and support services. ADCES encourages DCESs to share and promote this report with your colleagues, employers, legislators, and policymakers.
Send a letter to your legislators informing them of this report via the Legislative Action Center.