당뇨병 예방 프로그램
배경
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.
DPP는 당뇨병 전증 진단을 받은 Medi-Cal 수혜자가 제2형 당뇨병 발병을 예방하거나 지연시키는 데 도움을 주기 위해 고안된 증거 기반의 생활 습관 변화 프로그램입니다. Medi-Cal DPP 서비스를 제공하기로 선택한 의료기관은 CDC 지침을 준수하고 국가 당뇨병 예방 인정 프로그램(DPRP)과 관련하여 CDC 인증을 획득해야 합니다. DPP 서비스는 CDC가 승인한 커리큘럼을 사용하는 훈련된 동료 코치를 통해 제공됩니다.
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.
공지 사항
- 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.
상태 리소스
The following are state-generated resources and reference materials for beneficiaries and providers regarding Medi-Cal’s DPP benefit:
- 신규 및 기존 제공자를 위한 DHCS 정보입니다: 등록을 위한 DPP 요건.
- 승인된 DPP 제공업체 목록.
- 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.
- 보장 및 상환 정책: 등록된 DPP 제공자로 승인된 Medi-Cal FFS 제공자는 제공한 DPP 서비스에 대한 청구서를 제출할 수 있습니다. 청구 정보는 DPP용 제공자 매뉴얼(Medi-Cal )을, 등록 정보는 FAQ를 참조하세요.
- 관리형 케어 전체 플랜 편지: 모든 플랜 레터 18-018은 Medi-Cal Managed Care 플랜에 대한 지침을 제공하며 Medi-Cal DPP 제공업체를 위한 것이 아닙니다.
- 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.
- 국회 법안 1810(2018년 예산위원회, 34장 법령)
- 상원 법안 97(상원 예산위원회, 2017년 법령 52장)
- If you have any questions about Medi-Cal’s DPP, please email: medi-cal.benefits@dhcs.ca.gov.
연방 리소스
다음은 수혜자 및 제공자를 위해 연방 정부에서 생성한 DPP 리소스 및 참고 자료입니다: