Remember how excited we were with the Balanced Budget Act of 1997? Everyone who reached out to their legislators made a difference.
We need you now. Go to the AADE Advocacy Center and ask your legislators to co-sponsor Senate 945 / HR Bill 1274, the Access to Quality Diabetes Education Act of 2013.
The Balanced Budget Act of 1997 defined the criteria for Medicare reimbursement of Diabetes Self-Management Education / Training:
- A CMS recognized program via accreditation or recognition.
- A referral from a recognized provider.
- A Medicare provider number.
The original bill included Certified Diabetes Educators recognition as Medicare providers. This provision fell out during the reconciliation between the House and the Senate. AADE has introduced legislation every congressional session to correct this oversight.
The cost savings and complications reduction is well known by CMS. The missing critical piece is “what is a diabetes educator?” What criteria defines us?
Please consider the following from the NCBDE website:
To clarify the information on the website, “holding the CDE credential does not confer any permission to manage diabetes beyond the limitations of the individual’s professional practice.”
Let me try to connect the dots. As a pharmacist, nurse, dietitian, etc., you have skills. Some of your skills cross over into another profession’s area of expertise. Your registration or license allows your practice there within the scope of practice of your license.
If you look at the AADE7, we are all expected to practice up to the AADE7 - the National DSME and Support Standards require these topics to be covered within a comprehensive DSME program. FACT: There is not a single healthcare discipline that includes comprehensive practice within the scope of the AADE7.
The above portrays why diabetes educators a struggling for Medicare recognition as providers.
So what does this mean? As the Affordable Care Act moves toward implementation, insurers are defining future healthcare coverage and who will be a recognized provider. Currently, diabetes educators do not have what it will take to be a recognized provider of the ACA essential health benefits. AADE is concerned that the absence of a legal definition of what a diabetes educator is and the Scope of Practice for the diabetes educator could significantly limit DSME availability in the future and restrict employment opportunities for diabetes educators.
So how do we define ourselves? Licensure recognized the healthcare providers, define a criteria for licensure and defines a scope of practice for the diabetes educator discipline. The push for licensure at the state level will legally define diabetes educators and define a legal scope of practice.
Please post your discussions on the My AADE Network so that others across the state my participate in the discussion.