February 2007
Provider Types Affected
Registered dietitians or nutrition professionals providing services to Medicare beneficiaries
Provider Action Needed
This article is based on Change Request (CR) 5426 which updates the Medicare Benefit Policy Manual (Publication 100-02, Chapter 15, Section 40.4) to include registered dietitians and nutrition professionals in the list of practitioners who can opt out of Medicare if certain conditions are met, and to provide services through private contracts that would otherwise be covered by Medicare.
Background
Prior to enactment of the Medicare Benefits Improvement and Protection Act of 2000 (BIPA), the Social Security Act (Section 1802(b)(5)(C)) did not include registered dietitians or nutrition professionals among the list of practitioners who may choose to opt out of Medicare.
BIPA (Section 105(d)) amended the definition of practitioner included in the Social Security Act (Section 1842(b)(18)(c)) to include registered dietitians or nutrition professionals in the list of practitioners who can opt out of Medicare if certain conditions are met.
CR5426 amends the Medicare Benefit Policy Manual (Publication 100-02, Chapter 15, Section 40.4 (Definition of Physician/Practitioner)) to include registered dietitians and nutrition professionals to be consistent with the Social Security Act (Section 1802(b)(5)(C)). The revised section 40.4 (Pub. 100-02, Chapter 15) is attached to CR5426.
Additional Information
The official instruction, CR5426, issued to your carrier or A/B MAC regarding this change may be viewed at http://www.cms.hhs.gov/Transmittals/downloads/R62BP.pdf on the CMS website.
If you have any questions, please contact your state's Provider Contact Center.
MLN Matters MM5426