Medicare Leaves Diabetes Educators and Patients Out in the Cold

 1000 diabetes education programs to lose funding based on HCFA’s ruling on how funding for diabetes education will be spent!

The Health Care Finance Administration (HCFA) issued its long-awaited final ruling on how funding for diabetes education will be spent.  The decision, a follow-up to its two-year-old proposed ruling became effective on February 27, 2001.

The New ruling will cause 1000 education programs to lose funding.  The decision comes after $388 million in funding was designated for diabetes education. However prior to this ruling, the majority of the money remained untouched because the agency had not finalized the process by which the money would be spent.

The two major parties concerned with the ruling-The ADA and the AADE-say they are in agreement with some aspects of the outcome.  How can anyone be satisfied with the outcome that will close 1000 programs and leave 736 programs to take care of the ten million seniors and those with disabilities who have diabetes.  That is about 14,000 patient’s for every program.

The major fault with the final ruling is that diabetes programs must be approved by the ADA in order to be eligible to receive Medicare coverage.  This rules out many programs that do not have an education credential from the ADA.  It is very costly and time consuming to have your program ADA recognized and most small facilities and those in rural areas will be left out in the cold.

The decision has taken the diabetes community by surprise and according to many educators; untold numbers of Medicare recipients who count on the programs are being forced to travel up to hundreds of miles to attend those that are HCFA approved.

The AADE requested an 18-month delay in requiring hospitals currently getting Medicare reimbursement to go through the ADA-recognition process.  But just as the Bush administration vetoed many environmental issues, he denied the request for the delay.

Because many of the programs can no longer get reimbursed for their programs, they will have to charge the patients.  That means that most will not be able to afford the programs and most facilities will most likely drop their diabetes programs and not have a need for their diabetes educators.

So in a time when we are having an epidemic of diabetes, the government has decided to limit access to the millions of people with diabetes.   The government is being very short sided because if diabetes is 27% of the Medicare budget today, over 100 Billion dollars now, imagine what it will be in just a couple of years, 50% of the Medicare budget?

When will they understand that diabetes cannot be controlled without empowering the patient with knowledge to self-manage their diabetes?