Center for Medicare and Medicaid Services (CMS) Announces New Services

Beginning in 2005, all newly enrolled Medicare beneficiaries will be covered for an initial physical examination, all beneficiaries will be covered for cardiovascular screening tests, and those at risk will be covered for a diabetes screening test in order to increase early detection  of this life-threatening condition.

       Included are:

1. Review of the individual's medical and social history with particular attention to modifiable risk factors for disease.

Medical history is defined to include, at a minimum, the following:

1. Past medical and surgical history, including experiences with illnesses, hospital stays, operations, allergies, injuries and treatments.
2. Current medications and supplements, including calcium and vitamins.
3. Family history, including a review of medical events in the patient's family, including diseases that may be hereditary or place the individual at risk.

Social history is defined to include, at a minimum, the following:

1. History of alcohol, tobacco and illicit drug use.
2. Diet.
3. Physical activities.
   
   
4. Review of the individual's potential (risk factors) for depression, including past experiences with depression or other mood disorders, based on the use of an appropriate screening instrument for persons without a current diagnosis of depression, which the physician or other qualified nonphysician practitioner may select from various available standardized screening tests for this purpose and recognized by national medical professional organizations.
   
   
5. Review of the individual's functional ability, and level of safety, based on the use of appropriate screening questions or a screening questionnaire which the physician or other qualified nonphysician practitioner may select from various available screening questions or standardized questionnaires designed for this purpose and recognized by national medical professional organizations.

Review of the individual's functional ability and level of safety must include, at a minimum, a review of the following areas:

1. Hearing impairment.
2. Activities of daily living.
3. Falls risk.
4. Home safety.
   
   
1. An examination to include measurement of the individual's height, weight, blood pressure, a visual acuity screen, and other factors as deemed appropriate, based on the individual's comprehensive medical and social history, and current clinical standards (as noted in #1).
   
   
2. Performance and interpretation of an electrocardiogram.
   
   
3. Education, counseling and referral, as deemed appropriate by the physician or qualified nonphysician practitioner, based on the results of the first five IPPE elements described.
   
   
4. Education, counseling and referral, including a brief written plan such as a checklist, must be provided to the individual for obtaining the appropriate screening and other preventive services, which are separately covered under Medicare Part B benefits:
5. Pneumococcal, influenza, and hepatitis B vaccines and their administration
   1. Screening mammography,
   2. Screening pap smear and screening pelvic exams,
   3. Prostate cancer screening tests,
   4. Colorectal cancer screening tests,
   5. Diabetes outpatient self management training services,
   6. Bone mass measurements,
   7. Screening for glaucoma,
   8. Medical nutrition therapy services,
   9. Cardiovascular screening blood tests, and
   10. Diabetes screening tests.