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PA Bulletin, Doc. No. 01-12

NOTICES

DEPARTMENT OF PUBLIC WELFARE

Diabetes Outpatient Self-Management Training and Education

[31 Pa.B. 54]

   The purpose of this notice is to provide prior public notice of the Department of Public Welfare's (Department) intent to cover diabetes outpatient self-management training and education if prescribed by a health care professional legally authorized to prescribe such services. These services must be provided by licensed health care professionals with expertise in diabetes whose programs have received recognition by the Pennsylvania Department of Health (DOH) or the American Diabetes Association (ADA).

   Current legislation (Act 98 of 1998) requires certain insurers, including Managed Care Organizations under contract with the Department to provide coverage of diabetes outpatient self-management training and education including medical nutrition therapy for the treatment of insulin-dependent diabetes, insulin-using diabetes, gestational diabetes and noninsulin-using diabetes if prescribed by a health care professional authorized to prescribe such services under law. The Department also has elected to provide for payment of these services for Medical Assistance (MA) eligible recipients through its Fee-for-Service Program.

   An MA Bulletin will be issued to all providers enrolled in the MA Program and all Managed Care Organizations under contract with the Department. This Bulletin will address the requirements relating to the provision of and compensation for these services to MA eligible recipients.

Fiscal Impact

   Funding for the provision of diabetes outpatient self-management training and education has been addressed as part of the Medical Assistance Fee Schedule Revisions Public Notice.

Contact Person

   A copy of this notice is available for review at local County Assistance Offices. Interested persons are invited to submit written comments to this notice within 30 days of this publication. These comments should be sent to the Department of Public Welfare, Office of Medical Assistance Programs, Attention: Suzanne Love, Room 515 Health and Welfare Building, Harrisburg, PA 17105.

   Persons with a disability may use the AT&T Relay Service by calling (800) 654-5984 (TDD Users) or (800) 654-5988 (Voice Users). Persons who require an alternate format should contact Thomas Vracarich in the Office of Legal Counsel at (717) 783-2209.

FEATHER O. HOUSTON,   
Secretary

   Fiscal Note: 14-NOT-269. No fiscal impact; (8) recommends adoption. The costs associated with this notice were included in the increased costs shown for 14-NOT-265, Medical Assistance Program Fee Schedule Revision, and are therefore not shown as costs with this notice.

[Pa.B. Doc. No. 01-12. Filed for public inspection January 5, 2001, 9:00 a.m.]


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