Friday, December 16, 2011

Action Alert: Please sign this petition for RDs

In a recent decision memorandum by The Center for Medicare and Medicaid Services (CMS) regarding Intensive Behavioral Therapy for Obesity (CAG-00423N), CMS determined that potentially lifesaving and risk reducing preventive services for Obesity could only be furnished by primary care providers in the primary care setting (i.e. MDs, Clinical Nurse Specialists, Nurse Practitioners, and Physicians' Assistants).

These providers are certainly necessary health care professionals in the primary care setting but have (next to) no training in food and nutrition counseling, have no robust 'outcome data' showing their own professions have established benefit for long-term weight reduction, have no additional time in their already over-scheduled days in the clinics, plus all of these providers bill for their professional time at substantially higher rates than do Registered Dietitians (RDs).

As a result, CMS has eliminated the most qualified providers, notably Registered Dietitians (RDs), along with clinical psychologists and other specialists who have been able to produce the best results for weight reduction for obese patients and made a ruling that uses professionals at a higher cost than RDs. The decision prevents RDs from directly billing for obesity treatment services and from providing services outside of primary care setting, and thus limits access for older patients to qualified professionals that would help reduce a very high risk for many types of cancer such as esophagus, pancreas, kidney, colorectal, endometrial, and post-menopausal breast cancer. 

Please consider signing ADA's petition to President Obama to urge CMS to include RDs in obesity treatment. We need 25,000 signatures by January 7, 2012 for the White House to review this petition. (Note: I have heard that this website is often 'slow' and frustrating due to the high traffic it receives. It went quickly for me, but if it is slow for you, please hang in there and slog through the steps to sign in in order to add your name.)

(Note: here is the full link to this petition:!/petition/urge-cms-reconsider-its-decision-cag-00423n-excluding-registered-dietitians-direct-billing-obesity/tql0XYc2?

I have also sent urgently worded letters to all of my elected officials in Washington, DC (I had already sent a letter to President and Mrs. Obama before this petition was created) and a letter to the newly appointed Director of CMS who is Marilyn Tavenner. Her address is:
Marilyn Tavenner, Director
Centers for Medicare & Medicaid Services
7500 Security Boulevard,
Baltimore, MD 21244 

In addition, if you are so inclined, please share this announcement on your Facebook and other social networking accounts plus with clients, friends, and colleagues. I have done this, and several of my friends who are MDs have told me they are going to sign it and urge their colleagues to do the same.

We all know and acknowledge there is no single or simple answer to treating obesity (or preventing it), but by not including RDs as providers for an obesity diagnosis and treatment, CMS has shifted the care to health care professionals who are already over-worked, have no training in nutrition and weight loss counseling, cost more to the health care system, plus what is most worrisome to me, are likely to give up too soon and recommend drugs or bariatric surgery for these patients, both of which are more invasive, more expensive, increase risk of more complications (increasing cost and decreasing quality of life), and are not the highest quality medical care available.

I hope you will agree and sign this petition. Note: Anyone can sign - you do not need to be an RD or a health care professional.

I don't know if these petitions have any chance of being seriously reviewed with an action that requires a change at the highest level of CMS, but living here in SE Michigan where Detroit is known as "Hockey Town", a quote that is frequently used is "You have to shoot on goal to score". 

This petition is that shot on goal. I hope you will consider signing it. I did so on the first night it was posted. 

Thank you.

Diana Dyer, MS, RD

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