Medicare Now Covers Nutrition Therapy and Pain Management

Expanding the preventive services available to Medicare beneficiaries, CMS yesterday began covering nutrition therapy and pain management for millions of seniors -- two services "badly needed but little used by the elderly," the New York Times reports. The nutrition benefits, which have been long sought by dietitians, were approved by Congress in December 2000 after a National Academy of Sciences report concluded that such coverage would likely save the government money and help patients. The benefits will initially be available to more than seven million beneficiaries with diabetes or kidney disease, "helping them choose the kinds of foods that can control or treat their illnesses." Patients must first obtain a referral from their primary care doctor or the specialist coordinating their care, and then the government will pay for a "registered dietitian or other nutritional professional to assess the patients' needs, provide counseling and develop a treatment plan to improve the patients' diets." Based on the outcomes for diabetes and kidney disease patients, the HHS secretary will recommend to Congress whether the nutrition benefit should be extended to other beneficiaries, such as those with high blood pressure or high cholesterol. Cindy Moore, director of nutrition therapy at the Cleveland Clinic Foundation and a spokesperson for the American Dietetic Association, said, "There is enormous potential for medical nutrition therapy to save taxpayers dollars and improve the quality of life for patients. Diet has a major role in the management of diabetes and can help reduce the risk of getting many other chronic diseases of aging like heart disease, osteoporosis and cancer." HHS estimates that the nutrition benefit will cost $270 million in the first five years, exclusive of any savings that might result from reduced health costs.

Also yesterday, CMS established a reimbursement code allowing doctors to identify themselves as "specialists in pain management" -- a "major accomplishment for the field of pain medicine [that] will make it easier for doctors to bill Medicare for these services," the Times reports. The new code will "encourage" physicians to provide pain treatment to patients with such illnesses as arthritis and cancer. In addition, Dr. Albert Ray, president of the American Academy of Pain Medicine, said the code will make it "far easier for patients to identify and locate doctors who specialize in pain medicine." The Times reports that private insurers often follow Medicare's lead in coverage decisions; dietitians and pain medicine specialists are hopeful that the new rules will spur greater private coverage in these areas (Pear, New York Times, 1/1).