As you know, the Academy has been engaged in conversations with the Centers for Medicare & Medicaid Services (CMS) for approximately two years regarding therapeutic diet order regulations. These regulations preclude RDs from ordering patients’ diets and result in costly and harmful delays in patient care. We have met and communicated frequently with CMS on this issue and proffered letters evidencing the Academy’s rationale for allowing RDs to be able to independently change and order patient diets. Ensuring that RDs are able to practice at the fullest extent of our scopes of practice remains one of the Academy’s highest priorities.
This week (February 4, 2013), CMS announced in the press release that it is proposing a rule change that would, among other things, “Save hospitals significant resources by permitting registered dietitians to order patient diets independently, which they are trained to do, without requiring the supervision or approval of a physician or other practitioner. This frees up time for physicians and other practitioners to care for patients.” This exciting development is designed to help health care providers to operate more efficiently by getting rid of regulations that are out of date or no longer needed. Many of the rule’s provisions streamline the standards health care providers must meet in order to participate in the Medicare and Medicaid programs without jeopardizing beneficiary safety.
The proposed rule (http://www.ofr.gov/OFRUpload/OFRData/2013-02421_PI.pdf) is open for public comment until April 8, 2013. The Academy’s Policy Initiatives & Advocacy team and Quality Management team will collaborate to prepare comments in support of this rule change as it is significant for Academy members and for the patients they serve. Several particulars about the proposed rule change are important to note:
• The proposed rule, if adopted, would not take effect until later this year. RD practice in hospitals should not change until the final rule is published;
• The proposed rule would apply only to RDs privileged by hospitals. The Academy will continue to work with CMS to urge a separate regulatory change that would apply to RDs practicing in long term care or other facilities;
• CMS proposes to allow “licensed dietitians” to order patient diets. The Academy will work to ensure that only the qualified nutrition professional, with expertise mirroring that of the RD gold standard specified in the Social Security Act, will be able to order diets independently, thereby protecting patient health and realizing the cost savings associated with RD-ordered diets; and
• CMS has adopted the Academy-approved “therapeutic diet” definition and interpretive guidance for the Resident Assessment Instrument Manual 3.0. The Academy will work with CMS to encourage adoption of the definition for hospitals and across the continuum of care.
You can be assured that we will continue to provide all relevant data, information, and experiences resulting from the proposed rule in our communication and will encourage ongoing input from DPGs and affiliates on the impact of the rule and its implementation. The Academy will also coordinate with members to solicit support for the proposed rule from physician and non-physician providers, hospitals, and congressional champions.
Policy Initiatives and Advocacy Team and Quality Management Team
Link here for an Academy statement on the Affordable Healthcare Act.
On June 14, the Washington Post and Slate hosted “Future of Food Security for the 21st Century” which was co-sponsored by the Innovation Center for U.S. Dairy and the Academy of Nutrition and Dietetics. It brought together leaders in nutrition, government and business to collaborate on
a solutions-oriented discussion on the production and distribution of healthy and affordable foods to all Americans and discuss the role the U.S. plays in global food issues. The Academy was represented by Ethan, Glenna, Judy and me. Ethan kicked-off the event. There were, of course, many other RDs in attendance at the summit and others who viewed the event live on the Washington Post site.
Approximately 300 people attended the summit with thousands of others participating in the social media conversation to explore facets of food security. Please use this link for speaker highlights on the following sessions:
· An Overarching View of the Food Security Problem (Dan Glickman, Former Secretary, USDA; Robert Thompson, Visiting Scholar, SAIS, Johns Hopkins)
· A View from Congress (Senator Jon Tester, D- Montana; Senator John Hoeven, R-North Dakota)
· Innovations in Sustainable Food Production (Christopher Policinski, Land O’Lakes; Jason Clay, World Wildlife Fund; Samuel Allen, Deere & Company)
· How Do We Improve Access to Healthy Food in America? (Elaine Waxman, Feeding America; Jim Werkhoven, Werkhoven Dairy; Mike McCloskey, Select Milk Producers; Andrea Thomas, Wal-Mart)
· A Table for 9 Billion: Can We Feed the World? (Johanna Nesseth Tuttle, Center for International Strategic Studies; Liz Schrayer, US Global Leadership Coalition; Sonny Ramaswamy, National Institute of Food and Agriculture; Tony Hall; Alliance to End Hunger)
Overarching themes represented in the offline and online conversations included:
- Intersection between nutrition and sustainability: Many panelists noted the need for quality, abundant and affordable nutritious foods,
while also managing waste and environmental impact.
- Consumer education: Several panelists hit on the need for stronger understanding around food production methods, and the need for consumer education on where their food comes from.
- Technology as necessity: Panelists highlighted increased, more effective and efficient production across agriculture, as necessary to feed
a hungry population. Many also addressed the rapidly evolving culture of agriculture, and stressed the need to cultivate interest in farming among young people.
This event highlighted the dual issue of how hunger and obesity coexist in our country and abroad. The issue of the quantity of food that can be
secured and the nutritional quality of that food is becoming more important. With that in mind, the Academy of Nutrition and Dietetics has joined forces with National Dairy Council and Feeding America to help fight hunger and promote healthy food choices for the 49 million Americans who are food insecure. The announcement about our new collaboration was made at the summit by Elaine Waxman, Vice President of Research for Feeding America. Attached is a press release. As you know, National Dairy Council will make a $300,000 contribution to Kids Eat Right to fund grants, toolkits, etc. (direct support to our members) through the Academy Foundation.
This partnership encompasses the entire nutrition process from production to distribution. All three partners have established inroads into local communities (farmers, registered dietitians, food pantries, etc.) and will join forces to share expertise and resources, identify new ways of approaching nutrition education and access, and make a significant change in the way food insecure individuals nourish themselves and their families. While there are already great conversations happening about food security, we are excited that this unique partnership can make a significant difference and impact a great deal of people.
Now Available: Revised tool to support your efforts to expand coverage of MNT services
Attention RDs! The Academy of Nutrition and Dietetics is thrilled to announce the latest edition of its third-party payer brochure. With an updated look, new cost-effectiveness information and outcomes data, this timely resource is essential to your advocacy efforts.
This easy to read brochure has been used extensively as an advocacy tool by registered dietitians to initiate referrals and to expand insurance coverage for MNT services. The brochure can be used in meetings with private payers, government officials, physicians and other key decision makers to send a strong message on the value and expertise of the registered dietitian.
Email email@example.com with your name and address to receive a free hard copy of the new brochure. It can also be downloaded for free at www.eatright.org/coverage (click on Expanding Coverage). Or you can link directly here and download from our website.
This effort is a component of the Value of the RD campaign supported by the Commission on Dietetic Registration.
April 2012 - A message about Aetna and in-network claims
The Academy has received complaints from members about Aetna’s processing of certain in-network claims between January 2009 and the present. The complaints at issue relate to claims submitted by registered dietitians in-network with Aetna for services designated by CPT codes 97802-97804, 99401-99404, 99411-99412, G0270-G0271 and S9470 when billed with appropriate ICD-9 codes and the claim was denied by Aetna with the reason listed in the Explanation of Benefits as “these expenses are not covered because this provider is not recognized under the member’s plan definition of a physician.” The Academy of Nutrition and Dietetics has brought this issue to Aetna’s attention. After thoughtful discussion we have reached an agreement and we are pleased to report that Aetna has agreed to reprocess these claims and make eligible for payment each such claim that is resubmitted.
The Academy thanks all members for their patience and support, as we work with Aetna to resolve this issue that has such important ramifications for members. This situation represents a vivid example of how membership in the Academy benefits dietetics practitioners, and how the Academy carefully makes use of members’ dues to simultaneously advance the profession, advocate for its members and protect and improve the nation’s health.