Re: Reimbursement for Obesity Counseling: So What?

[Guest guest]

I am totally baffled by this situation. Where is the ADA? Dietitians are the

only health professionals trained in weight management. Why is the

responsibility given to those untrained, particularly PA's and nurses? Why are

we, once again, left out. Now I have to tell patients that Medicare will cover

their weight management with a physician or their untrained staff but not me.

What a horrendous situation.

From: rd-usa [mailto:rd-usa ] On Behalf Of

Weaver

Sent: Tuesday, December 06, 2011 12:12 AM

To: rd-usa

Subject: Reimbursement for Obesity Counseling: So What?

But even if all of this were to move forward in tandem, physicians

would still be struggling to allocate time to weight management

counseling and away from other matters. The solution to this is for

physicians to initiate the counseling, and then defer to others better

suited to address the details. Dietitians are the obvious choice. In

some cases, health coaches could play this role as well. But for this

strategy to work, there would need to be reimbursement for that

counseling as well.

http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_1\

127032.html

--

Thanks, Weaver MS RD LD Medical Nutritionist/Medical

Assistant http://mdrdtherapy.com Medifast Take Shape For Life! Power

To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

http://victoriaweavermsrdld.tsfl.com Senior Executive Agent Insurance

Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

National Group Protection/24 Hour World/On Job Coverage/Non-Profit

FREE Quote http://victoriaweaver.abbaplans.com View our new

Testimonial Video Life Insurance for Life!

http://www.anallianceforlife.com/clients/video.html

[Guest guest]

ly, I am baffled too but for other reasons. I have read through the

comments that members of RD-USA have written about the CMS decision and what if

anything ADA is doing about their decision. Do you honestly believe that ADA

would just sit back and let this decision be made without lobbying on our

behalf? Has anyone even gone to the ADA website and read the statement issued

by the ADA in response to this decision? By the comments I've read, obviously

not.

We are in the practice of using evidence based analysis to make informed

recommendations and comments to our patients about medical nutrition therapy

treatments and yet many don't do their research when there are issues regarding

the reimbursement of our services by Medicare. I find that very disappointing.

Kathleen Wall, RD, CDE

CDA Healthcare Reimbursement Representative

>

> I am totally baffled by this situation. Where is the ADA? Dietitians are the

only health professionals trained in weight management. Why is the

responsibility given to those untrained, particularly PA's and nurses? Why are

we, once again, left out. Now I have to tell patients that Medicare will cover

their weight management with a physician or their untrained staff but not me.

What a horrendous situation.

>

> From: rd-usa [mailto:rd-usa ] On Behalf Of

Weaver

> Sent: Tuesday, December 06, 2011 12:12 AM

> To: rd-usa

> Subject: Reimbursement for Obesity Counseling: So What?

>

>

>

> But even if all of this were to move forward in tandem, physicians

> would still be struggling to allocate time to weight management

> counseling and away from other matters. The solution to this is for

> physicians to initiate the counseling, and then defer to others better

> suited to address the details. Dietitians are the obvious choice. In

> some cases, health coaches could play this role as well. But for this

> strategy to work, there would need to be reimbursement for that

> counseling as well.

>

http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_1\

127032.html

>

> --

> Thanks, Weaver MS RD LD Medical Nutritionist/Medical

> Assistant http://mdrdtherapy.com Medifast Take Shape For Life! Power

> To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

> http://victoriaweavermsrdld.tsfl.com Senior Executive Agent Insurance

> Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

> Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

> National Group Protection/24 Hour World/On Job Coverage/Non-Profit

> FREE Quote http://victoriaweaver.abbaplans.com View our new

> Testimonial Video Life Insurance for Life!

> http://www.anallianceforlife.com/clients/video.html

>

>

>

>

[Guest guest]

Are you saying there is testimony from ADA? It would be helpful to all of us if

you were to post the statement since you appear to be a reimbursement

representative. Were you able to contribute to the statement? Thank you Raphaela

Rozanski, MS, RD, LDN

> >

> > I am totally baffled by this situation. Where is the ADA? Dietitians are

the only health professionals trained in weight management. Why is the

responsibility given to those untrained, particularly PA's and nurses? Why are

we, once again, left out. Now I have to tell patients that Medicare will cover

their weight management with a physician or their untrained staff but not me.

What a horrendous situation.

> >

> > From: rd-usa [mailto:rd-usa ] On Behalf Of

Weaver

> > Sent: Tuesday, December 06, 2011 12:12 AM

> > To: rd-usa

> > Subject: Reimbursement for Obesity Counseling: So What?

> >

> >

> >

> > But even if all of this were to move forward in tandem, physicians

> > would still be struggling to allocate time to weight management

> > counseling and away from other matters. The solution to this is for

> > physicians to initiate the counseling, and then defer to others better

> > suited to address the details. Dietitians are the obvious choice. In

> > some cases, health coaches could play this role as well. But for this

> > strategy to work, there would need to be reimbursement for that

> > counseling as well.

> >

http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_1\

127032.html

> >

> > --

> > Thanks, Weaver MS RD LD Medical Nutritionist/Medical

> > Assistant http://mdrdtherapy.com Medifast Take Shape For Life! Power

> > To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

> > http://victoriaweavermsrdld.tsfl.com Senior Executive Agent Insurance

> > Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

> > Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

> > National Group Protection/24 Hour World/On Job Coverage/Non-Profit

> > FREE Quote http://victoriaweaver.abbaplans.com View our new

> > Testimonial Video Life Insurance for Life!

> > http://www.anallianceforlife.com/clients/video.html

> >

> >

> >

> >

[Guest guest]

Are you saying there is testimony from ADA? It would be helpful to all of us if

you were to post the statement since you appear to be a reimbursement

representative. Were you able to contribute to the statement? Thank you Raphaela

Rozanski, MS, RD, LDN

> >

> > I am totally baffled by this situation. Where is the ADA? Dietitians are

the only health professionals trained in weight management. Why is the

responsibility given to those untrained, particularly PA's and nurses? Why are

we, once again, left out. Now I have to tell patients that Medicare will cover

their weight management with a physician or their untrained staff but not me.

What a horrendous situation.

> >

> > From: rd-usa [mailto:rd-usa ] On Behalf Of

Weaver

> > Sent: Tuesday, December 06, 2011 12:12 AM

> > To: rd-usa

> > Subject: Reimbursement for Obesity Counseling: So What?

> >

> >

> >

> > But even if all of this were to move forward in tandem, physicians

> > would still be struggling to allocate time to weight management

> > counseling and away from other matters. The solution to this is for

> > physicians to initiate the counseling, and then defer to others better

> > suited to address the details. Dietitians are the obvious choice. In

> > some cases, health coaches could play this role as well. But for this

> > strategy to work, there would need to be reimbursement for that

> > counseling as well.

> >

http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_1\

127032.html

> >

> > --

> > Thanks, Weaver MS RD LD Medical Nutritionist/Medical

> > Assistant http://mdrdtherapy.com Medifast Take Shape For Life! Power

> > To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

> > http://victoriaweavermsrdld.tsfl.com Senior Executive Agent Insurance

> > Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

> > Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

> > National Group Protection/24 Hour World/On Job Coverage/Non-Profit

> > FREE Quote http://victoriaweaver.abbaplans.com View our new

> > Testimonial Video Life Insurance for Life!

> > http://www.anallianceforlife.com/clients/video.html

> >

> >

> >

> >

[Guest guest]

It is disappointing that ADA's input wasn't more effective in persuading CMS to

recognize the value of dietitians. We have to strategize to be more effective.

Raphaela Rozanski, MS, RD, LDN

> > >

> > > I am totally baffled by this situation. Where is the ADA? Dietitians are

the only health professionals trained in weight management. Why is the

responsibility given to those untrained, particularly PA's and nurses? Why are

we, once again, left out. Now I have to tell patients that Medicare will cover

their weight management with a physician or their untrained staff but not me.

What a horrendous situation.

> > >

> > > From: rd-usa [mailto:rd-usa ] On Behalf Of

Weaver

> > > Sent: Tuesday, December 06, 2011 12:12 AM

> > > To: rd-usa

> > > Subject: Reimbursement for Obesity Counseling: So What?

> > >

> > >

> > >

> > > But even if all of this were to move forward in tandem, physicians

> > > would still be struggling to allocate time to weight management

> > > counseling and away from other matters. The solution to this is for

> > > physicians to initiate the counseling, and then defer to others better

> > > suited to address the details. Dietitians are the obvious choice. In

> > > some cases, health coaches could play this role as well. But for this

> > > strategy to work, there would need to be reimbursement for that

> > > counseling as well.

> > >

http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_1\

127032.html

> > >

> > > --

> > > Thanks, Weaver MS RD LD Medical Nutritionist/Medical

> > > Assistant http://mdrdtherapy.com Medifast Take Shape For Life! Power

> > > To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

> > > http://victoriaweavermsrdld.tsfl.com Senior Executive Agent Insurance

> > > Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

> > > Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

> > > National Group Protection/24 Hour World/On Job Coverage/Non-Profit

> > > FREE Quote http://victoriaweaver.abbaplans.com View our new

> > > Testimonial Video Life Insurance for Life!

> > > http://www.anallianceforlife.com/clients/video.html

> > >

> > >

> > >

> > >

[Guest guest]

It is disappointing that ADA's input wasn't more effective in persuading CMS to

recognize the value of dietitians. We have to strategize to be more effective.

Raphaela Rozanski, MS, RD, LDN

> > >

> > > I am totally baffled by this situation. Where is the ADA? Dietitians are

the only health professionals trained in weight management. Why is the

responsibility given to those untrained, particularly PA's and nurses? Why are

we, once again, left out. Now I have to tell patients that Medicare will cover

their weight management with a physician or their untrained staff but not me.

What a horrendous situation.

> > >

> > > From: rd-usa [mailto:rd-usa ] On Behalf Of

Weaver

> > > Sent: Tuesday, December 06, 2011 12:12 AM

> > > To: rd-usa

> > > Subject: Reimbursement for Obesity Counseling: So What?

> > >

> > >

> > >

> > > But even if all of this were to move forward in tandem, physicians

> > > would still be struggling to allocate time to weight management

> > > counseling and away from other matters. The solution to this is for

> > > physicians to initiate the counseling, and then defer to others better

> > > suited to address the details. Dietitians are the obvious choice. In

> > > some cases, health coaches could play this role as well. But for this

> > > strategy to work, there would need to be reimbursement for that

> > > counseling as well.

> > >

http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_1\

127032.html

> > >

> > > --

> > > Thanks, Weaver MS RD LD Medical Nutritionist/Medical

> > > Assistant http://mdrdtherapy.com Medifast Take Shape For Life! Power

> > > To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

> > > http://victoriaweavermsrdld.tsfl.com Senior Executive Agent Insurance

> > > Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

> > > Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

> > > National Group Protection/24 Hour World/On Job Coverage/Non-Profit

> > > FREE Quote http://victoriaweaver.abbaplans.com View our new

> > > Testimonial Video Life Insurance for Life!

> > > http://www.anallianceforlife.com/clients/video.html

> > >

> > >

> > >

> > >

[Guest guest]

It is disappointing that ADA's input wasn't more effective in persuading CMS to

recognize the value of dietitians. We have to strategize to be more effective.

Raphaela Rozanski, MS, RD, LDN

> > >

> > > I am totally baffled by this situation. Where is the ADA? Dietitians are

the only health professionals trained in weight management. Why is the

responsibility given to those untrained, particularly PA's and nurses? Why are

we, once again, left out. Now I have to tell patients that Medicare will cover

their weight management with a physician or their untrained staff but not me.

What a horrendous situation.

> > >

> > > From: rd-usa [mailto:rd-usa ] On Behalf Of

Weaver

> > > Sent: Tuesday, December 06, 2011 12:12 AM

> > > To: rd-usa

> > > Subject: Reimbursement for Obesity Counseling: So What?

> > >

> > >

> > >

> > > But even if all of this were to move forward in tandem, physicians

> > > would still be struggling to allocate time to weight management

> > > counseling and away from other matters. The solution to this is for

> > > physicians to initiate the counseling, and then defer to others better

> > > suited to address the details. Dietitians are the obvious choice. In

> > > some cases, health coaches could play this role as well. But for this

> > > strategy to work, there would need to be reimbursement for that

> > > counseling as well.

> > >

http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_1\

127032.html

> > >

> > > --

> > > Thanks, Weaver MS RD LD Medical Nutritionist/Medical

> > > Assistant http://mdrdtherapy.com Medifast Take Shape For Life! Power

> > > To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

> > > http://victoriaweavermsrdld.tsfl.com Senior Executive Agent Insurance

> > > Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

> > > Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

> > > National Group Protection/24 Hour World/On Job Coverage/Non-Profit

> > > FREE Quote http://victoriaweaver.abbaplans.com View our new

> > > Testimonial Video Life Insurance for Life!

> > > http://www.anallianceforlife.com/clients/video.html

> > >

> > >

> > >

> > >

[Guest guest]

Raphaela, I couldn't agree with you more that we need to strategize. Call me a

" glass half full thinker " but I look at this as an opportunity for RD's.

Previously, no practitioner (including MD's) could bill Medicare for obesity

counseling. Now that this policy is taking effect it is crucial that RD's

market themselves to primary offices to ensure that RD's DO provide the direct

obesity counseling. I know of many RD's who are contracted with MD offices to

provide MNT and the MD pays them out of what he bills Medicare and insurance,

essentially meaning it takes away from his/her bottom line.

Now that an MD can submit claims to Medicare for obesity counseling that is more

money for them which in turn can be paid to the RD. We need be sure sure that

when we contract with primary care offices we do not undercut our contracted

rates! We know the MD is getting reimbursement and we should get a LARGE cut of

that paid by the MD to provide the obesity counseling. I speak locally to RD's

wanting to start a private practice or provide outpatient counseling and this

can be a great way to earn income and not have to set up an office with

overhead, etc.

CMS states in the policy that auxilliary personnel can provide the direct

counseling as long as the MD is present in the office suite or directly

available to provide assistance or guidance. We should be aggressive to get to

the MD's before they do let RN's and God forbid MA's provide the counseling.

Just my thoughts...

Kathleen Wall, RD, CDE

> > > >

> > > > I am totally baffled by this situation. Where is the ADA? Dietitians are

the only health professionals trained in weight management. Why is the

responsibility given to those untrained, particularly PA's and nurses? Why are

we, once again, left out. Now I have to tell patients that Medicare will cover

their weight management with a physician or their untrained staff but not me.

What a horrendous situation.

> > > >

> > > > From: rd-usa [mailto:rd-usa ] On Behalf

Of Weaver

> > > > Sent: Tuesday, December 06, 2011 12:12 AM

> > > > To: rd-usa

> > > > Subject: Reimbursement for Obesity Counseling: So What?

> > > >

> > > >

> > > >

> > > > But even if all of this were to move forward in tandem, physicians

> > > > would still be struggling to allocate time to weight management

> > > > counseling and away from other matters. The solution to this is for

> > > > physicians to initiate the counseling, and then defer to others better

> > > > suited to address the details. Dietitians are the obvious choice. In

> > > > some cases, health coaches could play this role as well. But for this

> > > > strategy to work, there would need to be reimbursement for that

> > > > counseling as well.

> > > >

http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_1\

127032.html

> > > >

> > > > --

> > > > Thanks, Weaver MS RD LD Medical Nutritionist/Medical

> > > > Assistant http://mdrdtherapy.com Medifast Take Shape For Life! Power

> > > > To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

> > > > http://victoriaweavermsrdld.tsfl.com Senior Executive Agent Insurance

> > > > Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

> > > > Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

> > > > National Group Protection/24 Hour World/On Job Coverage/Non-Profit

> > > > FREE Quote http://victoriaweaver.abbaplans.com View our new

> > > > Testimonial Video Life Insurance for Life!

> > > > http://www.anallianceforlife.com/clients/video.html

> > > >

> > > >

> > > >

> > > >

[Guest guest]

Raphaela, I couldn't agree with you more that we need to strategize. Call me a

" glass half full thinker " but I look at this as an opportunity for RD's.

Previously, no practitioner (including MD's) could bill Medicare for obesity

counseling. Now that this policy is taking effect it is crucial that RD's

market themselves to primary offices to ensure that RD's DO provide the direct

obesity counseling. I know of many RD's who are contracted with MD offices to

provide MNT and the MD pays them out of what he bills Medicare and insurance,

essentially meaning it takes away from his/her bottom line.

Now that an MD can submit claims to Medicare for obesity counseling that is more

money for them which in turn can be paid to the RD. We need be sure sure that

when we contract with primary care offices we do not undercut our contracted

rates! We know the MD is getting reimbursement and we should get a LARGE cut of

that paid by the MD to provide the obesity counseling. I speak locally to RD's

wanting to start a private practice or provide outpatient counseling and this

can be a great way to earn income and not have to set up an office with

overhead, etc.

CMS states in the policy that auxilliary personnel can provide the direct

counseling as long as the MD is present in the office suite or directly

available to provide assistance or guidance. We should be aggressive to get to

the MD's before they do let RN's and God forbid MA's provide the counseling.

Just my thoughts...

Kathleen Wall, RD, CDE

> > > >

> > > > I am totally baffled by this situation. Where is the ADA? Dietitians are

the only health professionals trained in weight management. Why is the

responsibility given to those untrained, particularly PA's and nurses? Why are

we, once again, left out. Now I have to tell patients that Medicare will cover

their weight management with a physician or their untrained staff but not me.

What a horrendous situation.

> > > >

> > > > From: rd-usa [mailto:rd-usa ] On Behalf

Of Weaver

> > > > Sent: Tuesday, December 06, 2011 12:12 AM

> > > > To: rd-usa

> > > > Subject: Reimbursement for Obesity Counseling: So What?

> > > >

> > > >

> > > >

> > > > But even if all of this were to move forward in tandem, physicians

> > > > would still be struggling to allocate time to weight management

> > > > counseling and away from other matters. The solution to this is for

> > > > physicians to initiate the counseling, and then defer to others better

> > > > suited to address the details. Dietitians are the obvious choice. In

> > > > some cases, health coaches could play this role as well. But for this

> > > > strategy to work, there would need to be reimbursement for that

> > > > counseling as well.

> > > >

http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_1\

127032.html

> > > >

> > > > --

> > > > Thanks, Weaver MS RD LD Medical Nutritionist/Medical

> > > > Assistant http://mdrdtherapy.com Medifast Take Shape For Life! Power

> > > > To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

> > > > http://victoriaweavermsrdld.tsfl.com Senior Executive Agent Insurance

> > > > Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

> > > > Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

> > > > National Group Protection/24 Hour World/On Job Coverage/Non-Profit

> > > > FREE Quote http://victoriaweaver.abbaplans.com View our new

> > > > Testimonial Video Life Insurance for Life!

> > > > http://www.anallianceforlife.com/clients/video.html

> > > >

> > > >

> > > >

> > > >

[Guest guest]

Ancillary services (RD'S and other services) for inpatient care are paid by

Medicare Part A and are reimbursed by DRG's (Diagnostic Related Groups), so

there is no opportunity for individual reimbursement by RD's. The Medicare part

B benefit under Medicare is for any outpatient care including MNT and the CPT

codes are used along with the ICD9 codes for individual reimbursement. Hope

this answers your question.

Kathleen Wall, RD, CDE

CDA Healthcare Reimbursement Rep

> >

> > I am totally baffled by this situation. Where is the ADA? Dietitians are

> the only health professionals trained in weight management. Why is the

> responsibility given to those untrained, particularly PA's and nurses? Why

are

> we, once again, left out. Now I have to tell patients that Medicare will

> cover their weight management with a physician or their untrained staff but

> not me. What a horrendous situation.

> >

> > From: _rd-usa _ (mailto:rd-usa )

> [mailto:_rd-usa _ (mailto:rd-usa ) ] On Behalf

Of

> Weaver

> > Sent: Tuesday, December 06, 2011 12:12 AM

> > To: _rd-usa _ (mailto:rd-usa )

> > Subject: Reimbursement for Obesity Counseling: So What?

> >

> >

> >

> > But even if all of this were to move forward in tandem, physicians

> > would still be struggling to allocate time to weight management

> > counseling and away from other matters. The solution to this is for

> > physicians to initiate the counseling, and then defer to others better

> > suited to address the details. Dietitians are the obvious choice. In

> > some cases, health coaches could play this role as well. But for this

> > strategy to work, there would need to be reimbursement for that

> > counseling as well.

> >

>

_http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_\

1127032.html_

>

(http://www.huffingtonpost.com/david-katz-md/obesity-counseling-reimbursement_b_\

1127032.html)

> >

> > --

> > Thanks, Weaver MS RD LD Medical Nutritionist/Medical

> > Assistant _http://mdrdtherapy.com_ (http://mdrdtherapy.com/) Medifast

> Take Shape For Life! Power

> > To Choose Optimal Health! 404 875-9919 Health Coach ID 30020181

> > _http://victoriaweavermsrdld.tsfl.com_

> (http://victoriaweavermsrdld.tsfl.com/) Senior Executive Agent Insurance

> > Producers of America LLC 3755 Marconi Dr Alpharetta GA 30005

> > Affordable Health/Life Insurance For Business CEOs & Self-Employeed!

> > National Group Protection/24 Hour World/On Job Coverage/Non-Profit

> > FREE Quote _http://victoriaweaver.abbaplans.com_

> (http://victoriaweaver.abbaplans.com/) View our new

> > Testimonial Video Life Insurance for Life!

> > _http://www.anallianceforlife.com/clients/video.html_

> (http://www.anallianceforlife.com/clients/video.html)

> >

> >

> >

> > [Non-text portions of this message have been removed]

> >

>

> [Non-text portions of this message have been removed]

>

>

>

>

>

>

>