Beyond the Strip
Improving Diabetes Management: Revenue opportunities for DMEPOS and Pharmacy
Sandra C. Canally RN, Founder and CEO
The Centers for Medicare and Medicaid Services (CMS) is leading the way to value-based care and paying for a provider’s proof of quality of service, improved health outcomes and lower costs. Certainly, the focus of CMS is on improving care and services to those beneficiaries that use the system the most, the chronically ill. A large group of the population affected, are those with diabetes.
DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics and Supplies) and pharmacy providers alike have an opportunity in the area of diabetes management. The shift to quality payment makes it imperative for providers to increase their offerings to their patients and offer services to differentiate themselves or be left behind.
Another service a provider can offer is Diabetes Self-Management Training (DSMT). The good news is that both DMEPOS and pharmacy providers are eligible.
Established criteria need to be met by the Medicare beneficiaries to make them eligible for this service:
• Diagnosed with diabetes
• Received an order for DSMT from the physician or a qualified Nurse Practitioner treating the Medicare beneficiary’s diabetes
CMS approval of The Compliance Team as an accredited DSMT program accreditation organization.
“The Compliance Team submitted all the necessary materials to enable us to make a determination concerning its request for initial CMS approval of its diabetes outpatient self-management training accreditation program. This application was determined to be complete on July 27, 2019. Under section 1865(a)(2) of the Act and our regulations at § 410.142, our review and evaluation of The Compliance Team will be conducted in accordance with our regulations . . . “
Note: DSMT programs are credentialed, not individual providers.
Since DSMT is not a separately recognized provider type, providers cannot enroll in Medicare for the sole purpose of providing DSMT.
DSMT is offered to providers who meet quality standards of a CMS-approved national accrediting organization, such as the American Diabetes Association, American Association of Diabetes Educators or The Compliance Team. (Note: CMS has declared that The Compliance Team’s AO application is complete, and formal CMS approval as a DSMT accreditor is expected by March 2020.) DMEPOS suppliers can be reimbursed for this training if they are enrolled with the A/B MAC and meet the accreditation standards.
Sign up now to enroll in the DSMT accreditation program, so that it will take effect in March 2020.
For more information go to the CMS website.
Competitive Bid Reminder
The next round of competitive bidding removes the national mail order restriction, so more providers can step up to the plate and specialize in diabetes.
The Compliance Team celebrates 25 years!
The Compliance Team recently traveled to beautiful Amelia Island, Florida, to celebrate their 25th Anniversary! Here, Sandy Canally, our Founder and CEO, stands next to Richard Canally, Senior V.P. next to the 25 year cake and, of course, celebratory balloons!
“In dealing with another well-known accreditation company, I felt as if it was a subservient relationship and they were doing me a great honor by accrediting my company. The Compliance Team is on the opposite end of that spectrum and collaboratively developed an accreditation plan that worked for us.
I was pleasantly surprised that the representative performing my on-site visit had previously been a DME owner. The representative was able to talk about industry trends and add value instead of just finishing the task at hand and leaving. The Compliance Team exceeded my expectations in every way.”
— Landon Groff, Owner, Maxwell Medical Services, San Antonio, TX
Exemplary Provider digital logos
We have new Exemplary Provider digital decals that you can add to your website or to your marketing materials. You can choose between generic or custom decals that include the accreditation tracks e.g. DMEPOS, Community Rx + DMEPOS, Long Term Care Pharmacy, Specialty Drug. Contact Marilyn, our communications advisor, for details, firstname.lastname@example.org.