Medicare patients at risk for Type 2 diabetes can soon take part in new diabetes prevention program

Effective April 1, 2018, your patients with Medicare who have Part B coverage and who are at risk for Type 2 diabetes are eligible for the Medicare Diabetes Prevention Program. It’s offered at no cost to the member.

In a random controlled trial, the program was proven by the National Institutes of Health to greatly reduce the progression of prediabetes to Type 2 diabetes. Program services are delivered by lifestyle coaches in community settings. The coaches are trained by organizations that are recognized by the Centers for Disease Control and Prevention.

Medicare criteria for eligibility are:

• Enrollment in Medicare Part B
• Blood value (one of the following):
• Fasting plasma glucose of 100-125 mg/dL
• A1c value between 5.7-6.4
• Oral glucose tolerance test between 140-199 mg/dL
• Body mass index greater than 25 (if Asian, greater than 23)
• No diagnosis of end-stage renal disease, Type 1 or Type 2 diabetes; previous gestational diabetes isn’t an exclusion to participation.

Information about how eligible members can enroll in the MDPP through our program administrator, Solera Health, will be available soon on web-DENIS. We’ll also provide enrollment details in the March Record.