Message from the Chairperson

Abstract

Dietetics, as we have been accustomed to, recently has changed dramatically with the legislative passage of the Beneficiary Improvement & Protection Act of 2000. Prospectively, the profession of dietetics will go down in history with the implementation of the Medicare Medical Nutrition Therapy (MNT) Act of 2001. For the first time, the Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Finance Administration, now covers MNT education to specific outpatient Medicare beneficiaries. This coverage falls under Medicare Part B for clients having a diagnosis of diabetes and/or chronic kidney disease. For ease of definition, Medicare will reimburse qualified dietitians and nutrition professionals who enroll in the Medicare program regardless of whether they provide MNT services in an independent practice setting or hospital outpatient department. Reimbursement for these MNT services does not include hospital inpatients, skilled nursing facility residents, or hospice patients. CMS has defined renal disease as chronic renal insufficiency for patients with a glomerular filtration rate between 13 to 50 mL/min and for post–kidney transplant care after hospital discharge. The final rule on Medicare MNT was issued on November 1, 2001. CMS clarified and expanded the definition for renal disease coverage that includes end-stage renal disease beneficiaries who are not receiving dialysis. In addition, it has extended the time period for which MNT would be covered for post–kidney transplant beneficiaries from 6 months to 36 months. To become a qualified provider, CMS will allow persons who are credentialed as “registered dietitians” with the American Dietetic Association (ADA) Commission on Dietetic Registration to use those credentials for proof of education and required professional experience. After completing the necessary enrollment forms, additional documents that may need to be submitted besides verification of “registered” status include a copy of state licensure or certification, if applicable, and a diploma indicating completion of a minimum of a bachelor's degree. A signed statement verifying completion of a supervised practice and/or internship program may also be needed. If practicing in more than 1 state, separate enrollment forms for each state and separate state licensure certification must be submitted. If a decision is made to pursue nutrition education reimbursement for the diabetic and/or chronic kidney disease client, which has been lack there of from Medicare in the past, be certain to investigate the options closely and carefully to become a Medicare MNT provider. The provider enrollment form can be accessed at the CMS Web site, which is http://www.hcfa.gov/Medicare/enrollment. Additional information can also be obtained through the ADA's Web site, which is http://www.eatright.org/gov/reimbursement.html. Another closely associated announcement recently has transpired in February 2002. The National Kidney Foundation (NKF) published the release of the Kidney/Disease Outcomes Quality Initiatives (K/DOQI) for chronic kidney disease. Details of these clinical practice guidelines can be found in the American Journal of Kidney Diseases and/or at the NKF Web site, which is http://www.kidney.org. The close connection between the Medicare MNT bill for chronic kidney disease and the K/DOQI clinical practice guidelines is paramount. Become informed and determine which reimbursement option is the most beneficial to you, the nutrition professional expert. It is now time for me to “switch hats” for the final time as the CRN/Clinical Nephrology Meetings (CNM) 2001-2002 Program Chair. I am grateful and very thankful for having the opportunity to work with 2 excellent and supportive Program Planning Committees and the NKF staff since the spring of 2000. They have assisted me with the detail planning and implementation of the successful 2001 CNM that was in Orlando, FL, last April and the April 2002 CNM in Chicago, IL. I am pleased and honored to hand over the reigns of the CRN/CNM Program Chair position to my successor, Cathi J. Martin, RD, CSR, LD, for CNM 2003-2004. She was my Co-Chair for CNM 2002 and also served on the CNM 2001 Program Planning Committee. Cathi is a Nephrology Research Coordinator at Vanderbilt University in Nashville, TN. She is also the CRN, Region II Alternate Representative and is currently the ADA-Renal Practice Group's Renal Nutrition Forum Newsletter Managing Editor. I have great confidence in her as she begins to “design” the CRN tracks for CNM 2003, which will be held in Dallas, TX, next April. Cathi welcomes your comments, suggestions, and ideas for CNM 2003 and can be reached via e-mail at [email protected] . In closing, I would like to share with you some words of wisdom. We are in the age of new opportunities for dietetics as MNT practitioners. Always remember that change is good and that we need to keep moving forward to face the new challenges that will occur. We also need to reflect back on where we have been to appreciate where we are going!