A message from Kurt Anderson at AADE:
As you may have noticed, Congress passed and the President signed a two year budget deal. Among the many provisions in this legislation is a section which deals with the Medicare Competitive Bidding Program for diabetes testing supplies (CBP). The CBP allows Medicare recipients to obtain their testing supplies in the mail via vendors who contract with Medicare. At the inception of this program, our members noticed that there were issues which negatively impacted patients. One of the most egregious issues included patients’ testing strips, to which they had become accustomed, being switched to an unfamiliar brand because the vendor did not carry that particular brand of strip. This unfamiliarity often lead to patients giving up on testing and some patients dying as a result. AADE was at the forefront of exposing these issues by surveying the contractors in this program. Starting in 2011 AADE wrote and published three “Secret Shopper Surveys” studies of this program. In addition, AADE has been working with many allies and Congress to address and improve the CBP.
Late last year, a bill was introduced in Congress which would address some of the issues with the CBP. AADE supported this legislation. Numerous attempts were made to attach the language from this bill to other pieces of legislation. The language was successfully attached to the budget bill. The two most important of these provisions include:
Strengthening the 50 Percent Rule
Under the CBP, suppliers are paid the same amount by Medicare for DTS regardless of what they supply to a beneficiary. As such, suppliers have a powerful economic incentive to maximize profits by offering the least expensive supplies obtainable. Congress was concerned that these incentives would lead suppliers to no longer offer many of the test systems commonly used by beneficiaries, and that beneficiaries therefore might not be able to find replacement supplies for their current test systems. Congress enacted the “50 Percent Rule” to ensure that beneficiaries would continue to have access to the same test systems that they used prior to implementation of the CBP by requiring that mail order suppliers make available at least 50 percent of all types of diabetes test supplies on the market before implementation of the CBP.
Strengthening the Anti-Switching Rule
CMS established the Anti-switching Rule to protect beneficiary and physician choice of glucose meters. This rule requires suppliers to furnish the test system requested by the beneficiary, and prohibits contract suppliers from influencing or incentivizing beneficiaries to switch their current glucose monitor and testing supplies brand to another brand.
AADE is also reaching out to the media via a press release, a copy of which is enclosed.
While the legislation will not correct all of the CBP’s issues, it is a relevant and big first step in improving the CBP.
The tenacity and dedication of our members to their patients was the key to this victory.
Kurt Anderson
Director of Federal and State Advocacy
The American Association of Diabetes Educators
200 West Madison/Suite 800
Chicago, IL 60606
Direct Line 312 601-4873
Cell 312 420-0920
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