As a Medicare/Medicare-Medicaid provider, you know that quality health care is a high priority for Fidelis Care and the Centers for Medicare & Medicaid Services (CMS). CMS considers statin use an important quality measure in patients with diabetes. For those 40-75 years of age with risk factors, the potential benefits of LDL–C lowering with a high-intensity statin are substantial.1 The current ACC/AHA Blood Cholesterol Guidelines recommend the use of moderate to high intensity statin therapy in patients with diabetes who are between the ages of 40 – 75 years. Individuals with diabetes experience greater morbidity and worse survival following the onset of clinical ASCVD (atherosclerotic cardiovascular disease). Treatment recommendations are noted in the table below:
CMS measures the use of statin medications in diabetics ages 40 to 75. Below are moderate to high intensity statins included in the CMS measure that are also covered on Fidelis Care’s formulary:
*Daily dose lowers LDL–C on average, by approximately 30% to <50%
**Daily dose lowers LDL–C on average, by approximately ≥50%
ᅀOne tab per day is covered (titration to higher dosage requires higher strength)
Please consider using one of these statins when treating your diabetic patients. If you have any questions, please call the Provider Call Center at 1-888-FIDELIS (1-888-343-3547).
- ACC/AHA Prevention Guideline: 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. Neil J. Stone, Jennifer G. Robinson, Alice H. Lichtenstein, et. Al. Circulation. 2014;129:S1-S45.