Congress Medicare Letter

January 26, 2007

The Honorable Sheldon Whitehouse
United States Senate
B-40D Dirksen Senate Office Building
Washington, DC 20510-3903

Dear Senator Whitehouse:

I am a member of a group of 170 Rhode Island State certified diabetes educators, many of whom are nationally certified and are affiliated with American Diabetes Association (ADA) recognized sites. I am writing to ask for your assistance regarding the discrepancy in reimbursement for diabetes education. It has created a barrier to care for your constituents in Rhode Island as well as country wide.

In order to be eligible to bill Medicare for diabetes education, a site must be American Diabetes Association recognized. To become ADA recognized, the site must have a registered nurse (RN) providing education. Currently, Medicare has a policy of not issuing provider numbers to registered nurses. The Centers for Medicare and Medicaid Services (CMS) will not process the applications due to this policy. If the RN service is required, there should be a way to bill Medicare for the diabetes education services the RN provides.

As a State association, we have attempted to make CMS aware of this inconsistency in the reimbursement policy and the need for a change. Since we have been unsuccessful in this endeavor, we are hopeful that your work at the national level will be met with success. Please feel free to have one of your staff contact me at (401) 435-7871 so we may work to correct this problem.

Sincerely,

ADDRESSES OF RI SENATORS AND REPRESENTATIVES

Representative Patrick J. Kennedy Congressional District 1 of RI

Representative James R. Langevin Congressional District 2 of RI

Senator Jack Reed of Rhode Island

Senator Sheldon Whitehouse of Rhode Island