MDPP Payments: Sequestration Guidance

Medicare Diabetes Prevention Program (MDPP) Suppliers:

Please see below for additional guidance pertaining to the 2% reduction in Medicare claim payments for the Medicare Diabetes Prevention Program.

Mandatory Payment Reduction of 2% for the Medicare FFS Program (“Sequestration”) Applies to All Medicare Diabetes Prevention Program (MDPP) Payments:

The Budget Control Act of 2011 mandated that Medicare Fee-For-Service (FFS) claims with dates-of-service on or after April 1, 2013, will incur a 2 percent reduction in Medicare payment. The claims payment adjustment will be applied to all claims after determining coinsurance, any applicable deductible, and any applicable Medicare Secondary Payment adjustments. All MDPP claims are subject to the 2 percent reduction in payment.

Please refer to this CMS March 3, 2016 MLN Article for additional information. Questions about reimbursement should be directed to your Medicare Administrative Contractor (MAC).

Are you an MDPP Supplier? Email us at MDPP@cms.hhs.gov and request to be added to our Supplier Listserv. This is the best way to ensure you receive communication specifically for suppliers!