• 2010: A new Patient's Bill of Rights goes into effect, protecting consumers from the worst abuses of the insurance industry. Cost-free preventive services begin for many Americans.
• 2011: People with Medicare can get key preventive services for free, and also receive a 50% discount on brand-name drugs in the Medicare donut hole.(copays waived)
• 2012: Accountable Care Organizations and other programs help doctors and health care providers work together to deliver better care.
• 2013: Open enrollment in the Health Insurance Marketplace begins on October 1st. (MNSure)
• 2014: Affordable Care Act implemented – Essential Health Benefits defined – MN’s health care reform set their own standards, exceeding the federal definitions
• See More http://www.hhs.gov/healthcare/rights/index.html
• January 1, 2002 - • Section 105 of the Medicare, Medicaid, and SCHIP
Benefits Improvement and Protection Act of 2000 (BIPA) permits direct Medicare coverage of Medical Nutrition Therapy (MNT) services when furnished by a registered dietitian or nutrition professional meeting certain requirements – Meet diagnostic criteria for diabetes or renal
disease (& 3 years post-transplant) – MD referral – 3 hours initial year/2 hours subsequent years If change in diagnosis/treatment, G0271 code = additional hours
AdditionalbillableservicesforRDN’s
• Diabetes Self Management Training (DSMT) – Initiated by Balanced Budget Act of 1997 – 10 hours of initial training & up to 2 hours follow-up each
year thereafter – Ordered by an MD – Program approved by ADA or AADE – G0108 - individual/ G0108 Group – Copays or deductibles apply for Medicare ! NationalDiabetesPreventionProgram
148.633 and Minnesota Rules, chapter 3250 provide the Minnesota Board of Dietetics and Nutrition Practice authority to act as the licensure agency for the practice of dietetics and nutrition
• 1994 session– May 5th presented to– May 9th signed by
governorOct 2000 Minnesota Board of Dietetics
& Nutrition Practice
May 13, 2013updated!
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HF195SignedintoLawMay13,2013
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Our Bill HF 195
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:�1.7Section1.[148.634]PRESCRIPTIONPROTOCOL.1.8Alicenseddietitianorlicensednutritionistmayimplementaprotocolthatdoes1.9notreferenceaspecificpatientandresultsinaprescriptionofalegenddrugthathas1.10beenpredeterminedanddelegatedbyalicensedpractitionerasdefinedinsection151.01,1.11subdivision23,whencaringforapatientwhoseconditionfallswithintheprotocol1.12specifiesthecircumstancesunderwhichthedrugistobeprescribedoradministered.�
ExcerptfromnewlawHF195(2013)
“Licensed practitioner” = MD; “Legend drug” = prescription drug 27
• Part B Medicare claims for MN, WI & IL • Effective Sept. 9, 2013
Need RDNs to become Medicare providers to demonstrate to Centers for Medicare/Medicaid Services that there is a supply available that could deal with an increased demand.
Provider enrollment & Claims: National Government Services, Inc. P.O. Box 6474 Indianapolis, IN 46206-6474
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QualityPaymentProgram(QPP)
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Two Tracks To Choose From:
OR
• PhysicianFeeScheduleImpact
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RDNs–EligibleClinicians(ECs)
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EligibleClinicianLook-UpTool
• DetermineYourParticipationStatus:
• https://qpp.cms.gov/participation-lookup
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Insurance
claim form:
In Minnesota, claims required to be submitted electronically, effective 2009
NPI
ICD-10
CPT - MNT
Tax I.D.
Must use April 1, 2014
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ICD-10CMcodes
International (Statistical) Classification of Diseases and Related Health Problems (10-1-2015, replaced ICD-9)
Disease codes & inpatient procedures, coding started post World War II
