Academy and CMS

Academy and CMS

October 2012

As another step in the Academy’s ongoing efforts to expand coverage opportunities for RDs within Medicare beyond diabetes and renal disease, Nutrition Services Coverage and Policy Initiatives and Advocacy staff met last Thursday with senior CMS officials, including Jonathan D. Blum (Acting Principal Deputy Administrator and Director, Center for Medicare) and Patrick H. Conway (Chief Medical Officer). Also in attendance were CMS staff from both the coverage and payment areas, Academy outside legal counsel from Arnold & Porter, LLP, and representatives from The Obesity Society and the Obesity Care Continuum. This meeting served as a follow up to a meeting held in May at which time CMS agreed to ask the Office of the General Counsel to review their statutory authority to expand the current Medicare Part B benefit. The meeting was extremely positive and opened the door for continued collaboration with CMS on this issue.

As you may remember, we experienced a setback in our coverage expansion efforts when, in the course of issuing its National Coverage Determination for Intensive Behavioral Therapy for Obesity, CMS stated they did  not have the statutory authority to expand the current Medicare Part B benefit beyond these two disease states. Since then, the Academy obtained several legal interpretations, including one from the Congressional Research Service, indicating that CMS did indeed have such authority. Over the summer we were successful in meeting with CMS staff and securing their agreement to review the relevant statutes in light of these reports.

Conversations with CMS will continue over the coming weeks and months as we explore together the regulatory options for coverage expansion.  The road ahead of us is still a long one and we appreciate your support.

(Provided by Marsha Schofield, MS, RD, LD
Director, Nutrition Services Coverage
Academy of Nutrition and Dietetics)

Anna Murphy