Medicare will NOW PAY for Supplementation, ie Vitamins, etc.

[Guest guest]

Nutrition Supplementation Recognized by Medicare

 

S. Randy Sarantos, DDS, MS, ABO, ABOM*

 

It was only a matter of time, but something revolutionary happened in medicine

on January 1, 2002. Medicare will recognize and pay for nutrition therapy for

the first time. It is estimated that nutrition benefits will be available to

more than seven million people who have diabetes and kidney disease (NY Times

1-1-2002) helping them to choose proper foods that can control or treat their

illness and Congress is considering expanding similar benefits to people

suffering from hypertension and other chronic disease states. This is truly a

major shift by government to address disease control through proper diet and

supplementation and opens up major positive opportunities in patient management.

 

Congress was motivated and influenced by a report from the National Academy of

Sciences that pointed out that such nutritional counseling coverage available to

Medicare patients would save money for Medicare and benefit patients. It is

strongly felt that Medicare's coverage will influence private insurers who are

already providing a limited amount of paid nutrition counseling services into

greatly expanding this valuable paradigm and that all insurance companies will

soon follow the example set by Medicare in recognizing the value of nutrition

counseling services to patients.

 

The Department of Health and Human Services estimates that Medicare will spend

$270 million on nutrition therapy benefits in the first 5 years. It has not yet

been estimated the savings that might result from a reduction in hospital

admissions, surgery and other costs which could be substantial. At the present

time Medicare provides health insurance for over 40 million people who are

elderly or disabled in which 6.3 million at 65 years of age or older have

diabetes and could qualify for nutrition counseling. This represents a

staggering 18 percent of the elderly suffering from this oftentimes deadly

disease. In addition, epidemiologist Josef Coresh (John Hopkins University)

reports that eight million people have lost at least half of their kidney

function and are likely to suffer the most severe nutritional deficiencies.

Many with kidney disease become nauseous, lose their appetite, have serious

chemical imbalances, become edematous and become more susceptible to

malnutrition and have a poor metabolism and overall general health and can be

positively helped from nutritional counseling.

 

Like any new paradigm introduced into the Medicare system where hundred of

million-of-dollars of cost are involved certain priorities must be addressed.

Certainly areas such as diabetes, kidney disease, pain management, cancer

support are key areas that require special attention to help those suffering

such maladies. There is no doubt that as the positive statistics come in as to

the efficacy of nutritional counseling, supplementation and diet control, that

eventually more and more areas of expanded coverage will be included. The hope

is that some day that nutritional counseling will be standard for all disease

conditions and even more important, be considered a standard for the prevention

of disease and not only as a reactive therapy after one is ill. It is clear

that we are at the frontier of recognizing the important role that nutrition can

play in helping mankind in their everyday struggle to maintain proper health and

wellness and that this industry will explode in the months and years ahead into

a major service area. The credibility and endorsement by the Congress in

approving payment for nutrition counseling was one of the breakthroughs needed

to legitimize the importance of this paradigm. Hopefully, the endorsement by

Congress will further motivate the private insurance industry to further expand

its already existing nutrition counseling and supplementation programs.

 

Nutrition therapy is viewed at present as an adjunct to other types of health

care that a patient receives primarily from a physician and a patient must

therefore have a referral from a treating practitioner or specialist

coordinating the patient's care in order for Medicare to pay for the services of

a registered dietitian or other nutrition professional to assess the patient's

needs, provide counseling and develop a treatment plan to improve the patient's

diet. The fact that Medicare has slowly been expanding the number of preventive

health care services which includes nutrition therapy illustrates a positive

trend that recognizes the need for alternative and preventive therapies such as

nutrition and which trend is expected to continue and be expanded in the future.

 

Based on the decision by Congress to recognize the importance of nutrition

counseling and paying for such services, rings the bells and whistles of the

entire health care industry and enormously raises the attention level of

millions of people who heretofore did not really take nutritional

supplementation, proper dieting and lifestyle changes seriously. This creates

enormous opportunities for practitioners everywhere to get involved in this new

health paradigm and start to set up Wellness Programs which can serve as a

platform to better develop a variety of nutrition wellness services for their

patients. More than ever, patients will be looking to their health care

providers to assist them in nutrition counseling and supplementation not only as

an adjunct to standard iatrogenic mechanical therapies but as alternative

preventive and long range maintenance therapies as well

 

We will see a grater demand for inexpensive in-home test kits to utilize

clinical metabolic laboratory testing to better focus and monitor chemical

imbalances and thus more accurately develop custom nutrition that targets and

focuses with greater accuracy on the chemical imbalances detected and provides

the basic nutrients needed to help the immune system and other specific body

systems to restore homeostasis and better health. This is an explosive area of

further growth and fits in well with the goals of Medicare and other private

insurance companies to provide nutrition counseling and supplementation with the

hopes that better health resulting from such programs will lower present costs

of insurance as well as stem the rapidly rising future costs. It is an area

that is wide open for developing inexpensive in-home test kits for diabetes,

kidney disease, obesity, allergies, osteoporosis and many other disease states

that when utilized by patients and sent directly into the laboratory for

analysis of the targeted body fluids collected would provide a highly accurate

and individualized metabolic analysis from which a customized supplemental

protocol could be provided for such patient at a modest cost. This would not

only be extremely cost effective but would be an important part of an overall

nutrition program for an individual and would be part of the trio of (1)

lifestyle changes and enhancements (2) dietary changes and (3) targeted and

balanced nutritional supplementation. The technology and wellness concept is

in place today to benefit millions of patients and is waiting for innovative and

forward-thinking practitioners to implement such programs for their patients.

 

In summation, a new level and heightened awareness of the benefits of

nutritional counseling is about to explode on the national scene that will have

profound positive health effects in the years ahead in one way or another on all

Americans. That paradigm is nutritional counseling as an adjunct to maintaining

health and wellness as well as being an adjunct to iatrogenic therapies. The

concept is not new but the recognition on a national and governmental level is!

This is where the breakthrough has occurred and why the momentum once begun will

become a groundswell of enormous proportions. Practitioners must wake up and

strongly position themselves with the knowledge and tools to implement an Office

Nutrition Wellness Program as a necessary and important practice management

component of their practice to meet the coming trend in providing their patients

with nutritional supplementation as an adjunct to iatrogenic mechanical

therapies and programs. I would venture to state that within 10 years that this

will be standard practice in most if not all health practitioners' offices.

Failure to do so will result in losing this important and valuable health

service to outside competing sources and even patients who will seek

practitioners who eagerly have set-up and provide such ancillary services.

 

*Dr. S. Randy Sarantos practiced clinical orthodontics for over 28 years and is

both a diplomate of the American Board of Orthodontics and a diplomate of the

American Board of Oral Medicine. Dr. Sarantos has been involved in nutrition

counseling for over 30 years with special emphasis on oral manifestations of

systemic diseases and has been a long time advocate of prescribing nutritional

supplementation too all patients as a positive adjunct to iatrogenic treatments

particularly in the case of mechanical therapies performed by practitioners.

 

Dr. Sarantos is president of Custom Nutrition Alternatives, Inc. and its

affiliated company Dental Nutrition Alternatives, Inc. Both scientific

research and development companies specialize in creating nutrition wellness

programs for use by health care practitioners for their patients using

cutting-edge scientific technology to help monitor patient nutritional needs and

create custom nutrition products.

 

NutSuppRecgMedicare

 

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