Medicare Caps Insulin for Part D Coverage at $35 per month in 2023

Starting in 2023, the cost of a one-month supply of each Part D-covered insulin will be capped at $35, and patients will not have to pay a deductible for insulin. This applies to everyone who takes insulin.

For insulin used with a traditional insulin pump that is covered under the Medicare durable medical equipment benefit, patients pay 20% of the Medicare-Approved Amount after they meet the Part B deductible.  Patients pay 100% for insulin-related supplies (like syringes, needles, alcohol swabs, and gauze), unless they have Part D.

Click here to read more.

Mississippi Offering Free Diabetes Prevention Lifestyle Coaching for Medicare Part B Beneficiaries

The Diabetes Coalition of Mississippi is supporting Mississippi Lifestyle Care a statewide delivery ecosystem for the Medicare Diabetes Prevention Program and Findhelp social needs resource program. Thanks to grant funding provided by Novo Nordisk, Inc., a Lifestyle Coach workforce is being deployed to provide these programs in every Mississippi zip code. Medicare Part B participants will have the opportunity to engage in free lifestyle coaching for a year.

Mississippi is one of the first states to have a statewide Lifestyle Coach workforce to provide access to diabetes prevention care bundled with social needs resources that will help Medicare Part B beneficiaries with diet, exercise, weight loss, lowering social needs barriers, and many other healthy lifestyle changes for a full year at no cost.

For those that qualify as having prediabetes, a Lifestyle Coach will provide in-person support to help participants feel good, look better, live longer, and reduce their chances of experiencing the onset of type 2 diabetes.

Prediabetes is a condition where individuals have higher than normal blood sugar which increase the risk of developing type 2 diabetes in the future.  It is estimated that 814,000 Mississippians have prediabetes, and many do not know it.

With eight in ten people on Medicare living with two or more chronic conditions and four in ten living with four or more, the writing is on the wall that something must be done to improve overall health outcomes.  It is critical to address burdensome health care costs for seniors with fixed incomes working to manage their budgets and their health.

Mississippi Lifestyle Care is focused on healthy lifestyle change to reduce the massive chronic disease burden on the state’s healthcare systems.  Never has a statewide effort launched a border-to-border Lifestyle Coach workforce to confront type 2 diabetes, obesity, and social determinants of health barriers.

Those who are interested in participating should visit to find out if they are eligible for the program.

DSMES Funding Opportunity

The Mississippi State Department of Health Diabetes Prevention and Control Program is excited to be providing a funding opportunity for new and existing Diabetes Self-Management Education and Support (DSMES) programs.  The purpose of this sub-grant is to support the delivery of DSMES in areas which have historically lacked access to evidence-based diabetes education services.  There will be a total of 6 sub-grants awarded totaling up to $25,000 each.  If you have any further questions after reviewing the application, we are inviting you to a scheduled informational session to be held on October 11, 2022, at 1:00 pm.  

Contact Monica Sawyer via email at for more information.  

Click here to view the subgrant funding opportunity details

Informational Meeting – October 11, 2022 at 1 p.m.
Click here to login
Meeting ID: 895 0322 5419 
Passcode: 9JCzrd

Isolation Does Not Mean Sedentary

Today I had a few back-to-back meetings as well as some article and policy reviews to work on. Besides the occasional 5-minute breaks, I remained seated. During this time of the year, our offices are swarmed with ladybugs, so there is the occasional swatting. However, I still remained seated. If this type of behavior goes on for five straight days, how might it affect my health? Edema may set it, along with poor circulation of the bloodstream.

The Covid-19 Pandemic has tremendously added to the stress we place on our bodies. There are no occasional visits to coworkers’ offices, no team lunch break walks in the parking garage or around the building. Lunches away from the office are almost unheard of now that many restaurants offer delivery and take outs. What we must remember is that we have a set of advanced skills. We can move our bodies with or without assistance to get the blood flowing. We can take our lunch break and walk around and choose to put on our mask. We can walk around the building inside and outside in shifts. We can choose to eat a lighter DASH lunch and save our heavier meals when we return home where some of us are sure to burn more calories, especially for those of us who don’t know how to sit down at home because there is always a dish or clothing to wash.

 As we embark upon 2022, let’s remember to be grateful and take care of our bodies. The Diabetes Coalition of Mississippi is here to help and is growing strong. We have a host of beautiful people working with us to help Mississippians prevent and control diabetes so that we can serve as a pillar of hope. We invite you to get involved and get moving towards improved health outcomes.

 Written by Tockie V. Hemphill, M.S.

MSDPP Update #3

Sometimes we assume that all the world sees the urgent need for type 2 diabetes prevention.  However, Mississippians have had little access to the CDC’s National Diabetes Prevention Program known as the National DPP, or the CMS Medicare DPP for the Medicare qualified.  Both programs are lifestyle change programs meant to slow, delay, or even reverse the onset of type 2 diabetes.  The Mississippi Diabetes Prevention Program (MSDPP) Network initially introduced on August 4th at the Mississippi Health Disparities Conference 2021 is structured to provide statewide delivery of the National DPP and Medicare DPP.

Who wants Diabetes Prevention in Mississippi?

The Diabetes Coalition of Mississippi and the Prevention Workstream have been working diligently to provide access.  The MSDPP Network structure is to establish and maintain a functional delivery ecosystem that features Healthcare PAYERS for sustainability and the Lifestyle COACH workforce for the point of care relationship with Prediabetes POPULATIONS.

Who doesn’t want Diabetes Prevention in Mississippi?

As we move forward, the actions by diabetes prevention stakeholders intended or unintended will determine the fate of National DPP and Medicare DPP statewide delivery in Mississippi.  Watch for the next update #4 on the MSDPP Network that will discuss each stakeholders’ role and their actions

MSDPP Update #2 – Lifestyle COACH Network

The Mississippi Diabetes Prevention Program (MSDPP) Network was discussed in depth during the monthly Prevention Workstream meeting on August 27th. This Diabetes Coalition of Mississippi discussion continues from the initial introduction of the MSDPP Network at the Mississippi Health Disparities Conference 2021 on August 4th, 2021. 

Of upmost importance is the role of the Lifestyle COACH for statewide distribution of the National DPP to provide the Access that Healthcare PAYERS must have to assure their beneficiaries can participate. The Prevention Workstream with the leadership of Lynn Ward has initiated the MSDPP Lifestyle Coach Network on Facebook for certified Lifestyle COACHES and those who want certification to collaborate and share experiences. 

To join the MSDPP Lifestyle Coach Network, use this link:

MSDPP Network Update

The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS) intended the National Diabetes Prevention Program (National DPP) and Medicare DPP respectively to significantly impact the 88 million Americans with prediabetes by preventing or delaying the onset of type 2 diabetes.  Program delivery must now shift from a predominately community health (grants and sponsorships) approach to business health (Healthcare PAYERS) funding, a functional delivery ecosystem that stakeholders believe is scalable and sustainable.

Recently the Mississippi legislature passed Senate Bill 2799, opening the door for the Division of Medicaid to offer the National DPP to beneficiaries directly and through their managed care organizations or MCO’s.  This is a significant opportunity for a government Healthcare PAYER to provide statewide access in Mississippi.  Along with original Medicare, the reimbursement potential can become realized for statewide diabetes prevention Access, Enrollment, and Outcomes.

This effort requires network strength, which is: Network Management, a Plug & Play PLATFORM, and a Lifestyle COACH workforce.  The Mississippi Diabetes Prevention Program (MSDPP) Network was outlined during the Realizing DPP track of speakers at the Mississippi Health Disparities Conference 2021 last week.  In the upcoming blog posts, the MSDPP Network will be described in detail from those conference presentations.  Stay tuned for the next MSDPP Network post.

Phil Trotter, Prevention Workstream Chair

What it Means to be Insulin Resistant

By: Dr. Catherine Moring, PhD, RDN, LD, BC-ADM, CDE, MCHES

When you hear the word insulin, what comes to mind? Have you ever thought much about the role of insulin in your body? Turns out, high insulin levels is one of the driving factors in why we gain weight, get heart disease (high cholesterol, blood pressure and triglycerides), metabolic syndrome, type 2 diabetes, PCOS, thyroid dysfunction, cancer, and obesity, to name a few. Let me explain.

Insulin is an anabolic, building storing hormone known as the “master” hormone. Hormones are basically messengers in the body that tell things what to do and where to go in order for our body to stay in balance and function well. In the case of insulin, it is made in the pancreas and is released in response to rising levels of blood sugar.

So, how does blood sugar rise? When we eat carbohydrates, especially refined, processed ones like bread, cereal, chips, crackers, rice, pasta, candy, soda and other sugar-sweetened beverages, corn and sugar, blood sugar levels rise tremendously. Insulin is then released from the pancreas in response to rising blood sugar levels and comes and takes the sugar from the blood to our body cells to store for use for energy later. The more carbohydrates, and the more often we eat, the more insulin is released. When we eat eggs, avocado, nuts, meats, and other low-or-no-carbohydrate foods hardly any insulin is released because there are few carbohydrates in those foods. Whereas, when we eat the aforementioned high carb foods, a lot of insulin is released because those foods are much higher in carbohydrates.

The process works fine until our cells become too full of sugar. Because of our tendency to overconsume, especially refined carbohydrates, our cells eventually become too full of sugar. We develop an energy storage problem. To protect themselves from damage due to toxic levels of sugar, they start ignoring insulin’s message to store sugar, becoming insulin resistant. The pancreas senses this and produces more insulin to keep blood sugar levels down. In someone who is insulin resistant, the pancreas releases 3-5 times more insulin to bring blood sugar to normal levels than someone who is insulin sensitive. When the storage problem arises and insulin has trouble moving the sugar from the blood stream into the cells, high blood sugar develops often eventually leading to type 2 diabetes.

I like to give this analogy to explain what happens in the body at the cellular level as we develop insulin resistance. This is a very simplified explanation, but it gives you a visual. Imagine you are in a hotel, and you go to get on the elevator. There is a bellman there and his job is to get people on the elevator, just as insulin’s job is to get sugar into the cells. The elevator door opens and it so full of people not even a baby could fit but the bellman is telling you and your friends to come get on. The elevator knows if it lets any more people on, it will break so it shuts its door and does not allow the bellman to open it to let any more people in. The cells are similar, they detect their storage capacity for sugar is maxed out and if anymore comes in, they will become damaged, so they resist insulin’s message to store sugar and become insulin resistant. Going back to the elevator example, the bellman then goes and gets his friends to help pry open the elevator door to get more people in. In a similar manner, the pancreas begins to produce more and more insulin to overcome the insulin resistance and pack more sugar into the cells. This is also how the blood levels of insulin become elevated which is associated with a myriad of chronic diseases, mentioned at the beginning of this article. Once someone develops insulin resistance, it takes 3-5 times more insulin to move the same amount of sugar into the cells as someone who is insulin sensitive, thus frequently elevated blood levels of insulin develop.

Just as high blood sugar levels are dangerous, long-term high blood levels of insulin are also dangerous. Unfortunately, many doctors don’t measure or talk about this as much. If we can address insulin resistance when it first develops, it is much easier to reverse so that a person can once again be insulin sensitive.  High insulin levels cause damage to the heart and the cardiovascular system and promote weight gain. The more insulin floating around in the blood stream, the more fat we store which leads to weight gain. Insulin stimulates the uptake of fatty acids by fat cells, which convert these molecules into triglycerides — the primary storage form of fat in your body. Thus, insulin promotes lipogenesis, the creation of new fat. Said another way, when our body has too much sugar that needs to be stored because we overconsume carbohydrates and are not very active, insulin changes sugar into triglycerides through a process called lipogenesis and stores it in our fat cells causing weight gain, leading to a whole host of other problems including metabolic syndrome and often eventually leading to type 2 diabetes. Another reason elevated insulin levels are problematic is that high levels of insulin block nutrient absorption thus causing nutrient deficiencies. It is common to see things like low potassium and low Vitamin D in people who have insulin resistance.

 When our cells start ignoring insulin’s message to store sugar, the pancreas produces more insulin to compensate for that to keep blood sugar levels down. Therefore, more insulin is present in the blood stream, leading to excess storage, weight gain, and host of other complications. Further, elevated insulin levels contribute to hardening of the arteries and constricts blood vessels causing high blood pressure. In fact, a very early warning sign of insulin resistance and the development of type 2 diabetes in some people is high blood pressure.

This whole process starts when we overCARBsume certain foods. Once we are insulin resistant, inflammation and other problems arise, including weight gain, metabolic syndrome and type 2 diabetes. Lowering our insulin levels is the real key to weight loss, weight management, sustained weight loss, reversing certain chronic health conditions and the damage done to our bodies. In order to lower insulin levels and improve your body’s sensitivity to insulin, you need to consume less carbohydrates and try to limit things like grains, bread, cereal, pasta, sugar sweetened beverages and other refined and processed carbohydrates. Fasting is also a great tool to lower insulin levels and promote insulin sensitivity.

So how do you know if you have high insulin levels or if you are insulin resistant? There are several ways to tell. If you have any of the following, you may have high insulin levels and/or insulin resistance: extra body weight especially around the stomach, a fasting blood sugar above 100, an A1C above 5.5, high cholesterol, high blood pressure, high triglycerides, muscle weakness, fatigue (tiredness), cognitive brain fog, loss of memory, vision problems, headaches, artery inflammation, skin tags, acne, PCOS, gout, fatty liver, obesity,  thyroid disfunction, not satisfied after eating, nutrient deficiencies, often feel hungry (cells are not well fed), and leptin resistance.

Food can be your medicine. If you suspect you have or may be developing insulin resistance, consider changing your diet to include anti-inflammatory low-carbohydrate foods such as non-starchy vegetables, eggs, meats, fish, nuts, and healthy fats. If you have questions or would like more information, please don’t hesitate to email me at

Snap Shot: What’s happening Federally and in other States regarding Diabetes Management & Pervention

Written by: Deborah Colby, MEd, RD, LD, CDE

Federal Advocacy:

  • House Diabetes Caucus Co-Chairs Diana DeGette (D-CO) and Tom Reed (R-NY) led a letter to the House Appropriations Committee requesting funding increases for diabetes prevention and research programs in NIH and the CDC for fiscal year 2022. The bipartisan letter was signed by more than 100 Members of Congress.
  • Reps. Tom Rice (R-SC), Tom Reed (R-NY), Diana DeGette (D-CO), and G.K. Butterfield (D-NC) reintroduced the  Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-Based Strategies (PREVENT) Diabetes Act. The bill would include virtual suppliers in the Medicare Diabetes Prevention Program to allow more people with diabetes to access it remotely.

State Levell:

  • Arkansas, Colorado, and North Dakota took tremendous steps toward bridging equity gaps in health care by adding coverage for continuous glucose monitors to their Medicaid programs.
  • The New York legislature passed the state budget, eliminating premiums for more than 400,000 New Yorkers enrolled in the state’s Essential Plan, which covers people who make too much to qualify for Medicaid but may be unable to afford an exchange plan.
  • West Virginia voted to retain state funding for diabetes ed/prevention. New York’s legislature rejected a proposal to cut 20% from funding for obesity and diabetes prevention efforts and Washington’s governor approved legislation increasing access to free and reduced-price school meals.
  • Alabama’s Governor and state legislature passed a bill to cap insulin co-pays for Alabamians on state-regulated health care plans.

How the New CDC COVID Guidance Impacts Diabetes Patients and Healthy Coping

Healthy coping, as a behavior, has been critical for coaching and success for people with diabetes in dealing with the ups and downs (no pun intended) of living with the diagnosis. It comes with additional stress, increased risk for depression and other mental health concerns, feeling isolated, overwhelmed when it comes to social events involving food, medications and finances related to medications and other health related costs. As if that were not enough, the global pandemic threw us all for a loop, and a lot of our usual healthy coping strategies like group fitness, social groups, gathering with friends, church or other outings became risky, especially for those with chronic conditions like diabetes and even more so for those in minority populations. While social distancing was necessary and effective for helping control the spread of the novel coronavirus while treatments and vaccines were being developed, the impact on our mental health and isolation was lonely and disorienting at best and devastating at worst. Through innovation, funding and scientific cooperation, the best and brightest minds have developed vaccines that have been distributed at record pace with public health officials leading the way. On April 27, 2021, the CDC released new recommendations for those that have been vaccinated that we can now recommend to our patients with diabetes. These include:

  • Walking, running or biking outdoors with members of your household without a mask
  • Attending small, outdoor gatherings with fully vaccinated family and friends without a mask
  • Attending a small, outdoor gathering with fully vaccinated and unvaccinated people without a mask
  • Dine at an outdoor restaurant with friends from multiple households without a mask
  • Go to outdoor concerts or sporting events with a mask (if in a crowd)
  • Go to movie theaters, malls or museums with a mask
  • Attend small gatherings with multiple households who are unvaccinated with a mask
  • Still avoid large gatherings
  • Avoid those who are exhibiting symptoms of COVID

As a reminder fully vaccinated means, 2 weeks or more after the 2nd Pfizer or Moderna vaccine or 2 weeks or more after a single Johnson and Johnson vaccine. If you need assistance finding a vaccine near you, please visit,  All of these activities that we can now participate in, thanks to vaccines and better control of COVID, are essential options for people with diabetes to begin accessing for healthy coping as alternatives to less than healthy ones that we can all default to. It is also important to remind patients that when if an unhealthy coping strategy is chosen, like overeating, smoking, overconsumption of alcohol or any other behavior that takes a person further from their goals, it is never an all or nothing decision. Keep a list of other strategies that work for you and that you enjoy and begin to use that one as soon as you realize you need it as well as scheduling it regularly before those others creep up due to stress or other reasons.

Written By: Ashley W. Ellis, PharmD, CDECS