In the $1.2 trillion budget package signed Tuesday, a little-known healthcare provision was reauthorized that will allow millions of people on Medicare to access diabetes prevention education online.
As part of the budget package, Congress passed the PREVENT DIABETES Act, which extends the ability for digital health companies (virtual suppliers) to participate in the Medicare Diabetes Prevention Program (MDPP) through the end of 2029.
Medicare Part B patients who are at risk for Type 2 diabetes can participate in the program for free, if they meet certain clinical thresholds for weight, blood pressure or blood glucose. The program lasts for a year and consists of 22 sessions on lifestyle changes to prevent diabetes.
Since the COVID-19 pandemic, virtual providers like Omada Health, 9am Health and Amwell have entered the business on temporary authority, much like other Medicare telehealth services.
However, major medical associations have urged Congress to permanently allow virtual-only providers to be recognized suppliers under the MDPP to expand availability of the prevention program and allow Medicare beneficiaries to attend synchronous virtual classes or watch recorded sessions on-demand.
“As of the end of 2022, cumulative MDPP enrollment stood at 4,848 Medicare beneficiaries, which is striking considering more than half a million participate in the CDC’s National DPP program when offered through their health plan or employer,” the National Endocrine Society, the American Diabetes Association and others wrote to Congress in 2024. “Many congressional districts lack in-person MDPP locations to serve the tens of thousands of at-risk constituents otherwise eligible for these services under Medicare.”
The Centers for Disease Control and Prevention (CDC) started the National Diabetes Prevention Program in 2010 to address the rising rates of Type 2 diabetes. It created a network of providers that teach a CDC-approved curriculum on lifestyle interventions for people with prediabetes.
The MDPP launched in April 2018, though diabetes education providers could only offer classes in person, often at community sites. When the COVID-19 pandemic hit, the suppliers were given permission to deliver the services remotely.
"We’re thrilled to hear about the passage of the PREVENT DIABETES Act,” Lucia Savage, chief privacy and regulatory officer of Omada Health, said in a statement to Fierce Healthcare. “We have been advocating and involved in the policy-making for virtual DPP and helped to draft the first version of this bill in 2018. This new law codified in statute that all CDC Fully Recognized DPRPs (Diabetes Prevention Recognition Program) in [the Centers for Medicare & Medicaid Services (CMS)]—including virtual programs like Omada—are able to serve the Medicare population.”
The legislation also allows Medicare patients to participate in the program more than once.
Savage noted that the CMS voluntarily included virtual-only providers in the CY2026 PFS, ensuring digital health companies would be paid for the services they provide to Medicare beneficiaries.
In the rulemaking, the CMS lifted the requirement that virtual providers maintain an in-person delivery capability to offer remote services, and it allowed patients to record their weight remotely.
Moreover, the CMS clarified in an FAQ page that texts and messaging can count as one-on-one coaching, so long as the interaction is bidirectional.
Patients still have the option to receive MDPP in person from certified providers.