糖尿病予防プログラム
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California state law requires the Department of Health Care Services (DHCS) to establish the Diabetes Prevention Program (DPP) as a Medi-Cal covered benefit. Medi-Cal’s DPP benefit will be consistent with the federal Centers for Disease Control and Prevention’s (CDC’s) guidelines and will also incorporate many components of the Centers for Medicare & Medicaid Services’ (CMS’) DPP in Medicare.
DPPは、前糖尿病と診断されたMedi-Calの受益者が2型糖尿病の発症を予防または遅らせるのを支援するために設計された、エビデンスに基づくライフスタイル変更プログラムです。 DPPサービスを提供することを選択したMedi-Calプロバイダーは、CDCのガイダンスに準拠し、National Diabetes Prevention Recognition Program(DPRP)に関連してCDCの承認を取得する必要があります。 DPPサービスは、CDCが承認したカリキュラムを使用する訓練を受けたピアコーチを通じて提供されます。
Medi-Cal’s DPP will include a core benefit consisting of at least 22 peer-coaching sessions over 12 months, which will be provided regardless of weight loss. In addition, beneficiaries who achieve and maintain a required minimum weight loss of 5 percent from the first core session will also be eligible to receive ongoing maintenance sessions, after the 12-month core services period, to help them continue healthy lifestyle behaviors. The CDC’s DPP curriculum promotes realistic lifestyle changes, emphasizing weight loss through exercise, healthy eating and behavior modification.
お 知らせ
- On September 28, 2021, DHCS held a stakeholder meeting to discuss changes to the regulatory bulletin entitled, “Updated Medi-Cal Enrollment Requirements and Procedures for Diabetes Prevention Programs.”
- Beginning February 4, 2022, pharmacies that submit an application for enrollment can report providing DPP services in their primary application, and currently enrolled pharmacies can report providing these services by submitting a supplemental change form. The application for enrollment and supplemental change form must be submitted through the PAVE Portal.
- Additionally, in accordance with the Centers for Medicare & Medicaid Services’ Calendar Year 2022 Physician Fee Schedule Final Rule, DPP providers are no longer considered institutional providers. Therefore, all applications received on or after January 1, 2022, will no longer require an application fee.
州のリソース
The following are state-generated resources and reference materials for beneficiaries and providers regarding Medi-Cal’s DPP benefit:
- 新規および既存のプロバイダー向けのDHCS情報: 登録のためのDPP要件。
- 承認されたDPPプロバイダーのリスト。
- DHCS and CDPH presented information about the Medi-Cal DPP benefit at the quarterly Prevent Diabetes STAT webinar on February 25, 2019: PowerPoint Slides.
- Frequently Asked Questions: DHCS’ responses to commonly asked questions regarding Medi-Cal’s DPP benefit.
- 補償範囲と払い戻しポリシー:登録されたDPPプロバイダーとして承認されたMedi-Cal FFSプロバイダーは、提供されたDPPサービスに対する請求を提出することができます。 請求情報についてはDPPのMedi-Calプロバイダーマニュアルを、登録情報についてはFAQを参照してください。
- マネージドケアオールプランレター: すべてのプランレター18-018は、特にMedi-Calマネージドケアプラン向けのガイダンスを提供し、Medi-CalDPPプロバイダーを対象としていません。
- DPP Curriculum Translations: The National Association of Chronic Disease Director’s National DPP Coverage Toolkit now includes the National DPP Curriculum and its various translations. You can also view and download the CDC-developed and approved PreventT2 Curriculum and accompanying handouts, available in English or Spanish on CDC’s National Diabetes Prevention Program website.
- 議会法案1810(予算委員会、第34章、2018年制定法)
- 上院法案97(予算委員会、第52章、2017年制定法)
- If you have any questions about Medi-Cal’s DPP, please email: medi-cal.benefits@dhcs.ca.gov.
連邦政府のリソース
以下は、連邦政府が作成したDPPリソースと、受益者とプロバイダー向けの参考資料です。
- メディケア：
- 疾病管理予防センター：