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Medicare DME Competitive Bid Program

By Beth Cook posted 05-27-2013 07:18

  

I am sure most or you are already aware of what is coming down the pike effective July 1, 2013 for Medicare DM testing supply reimbursement but thought this was a a great topic to review.   So we know that Medicare's DME Competitive Bid Program will certainly effect you and how you help your patients manage their blood sugars.  With MI BCBSM jumping on board with the same program, it is surely impacting all DM patients in the state of MI. 

I wanted to share with you what our small Acute care Hospital is hoping to implement to help our DM patients.  Our HME/pharmacy currently has stock for 17 different types of test strips! Yikes.  Our DM team here are working to standardize the glucometers we hand out down to 2 or 3 different brands therefore streamlining the test strips in our HME/pharmacy.  We will carry the Bayer Contour, which is covered by Medicaid, but are still looking at others.   Patients will need to come into the clinic to pick up a new glucometer and get trained by our DM staff, which we hope may ultimately increase our clinic visits!  Our administration realizes that we will take a hit financially on covering the costs of the test strips but we will keep our patients as customers for their other medications.  We plan to send a letter out to all of our DM patients with this information and hope we can help with this transition. 

What ideas or changes do you think may work in your setting and how are they being addressed? Please share.  July is coming up on us fast!

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05-31-2013 13:49

Medicare website problems- response

Hi Linda,


When you go to the medicare website to see the suppliers - after you put in your zip code you have to click on the button that says "show all results" then it should populate several pages. You can also use this website to show the products available, however, I was told by a DME representative that the results aren't final as they were submitted before the reimbursement rate was set. Our office will be sending Medicare patients to Binsons DME (we're on the east side of Michigan) CareLinc seems to be the only local DME for the west side.

05-28-2013 14:15

Medicare website problems

Have had two patients tell me that they got a letter from Medicare last week about the changes with competetive bidding and it directed them to the medicare website (medicare.gov/supplierdirectory)  When you go there and enter your zip code, nothing happens.  I called medicare(last week) and they said it was working fine.  Then, she refreshed her page and saw that it was not working.  She said she would "make a ticket out about  this."  It still is not functional today.  Anyone else having/seeing these problems?  I know there are a lot of issues her about how to help keep patients on the meters they like, but I'm annoyed that even Medicare can't give people information!

05-28-2013 08:34

medicare competitive bidding

Our hospital does not have their own retail DME or pharmacy. I have been told by patients that their DME provider told them their "name brand" meter is no longer covered by Medicare and they have to use (what I refer to as) a "bargain brand" or the pharmacy's store brand. This has made for some unhappy people, who do not like having to switch meters. Our Roche rep told me that if the doctor writes a particular brand on the prescription, the supplier has to provide that brand. However, I read at the CMS website that the doctor will also be required to document why the patient needs to have that particular brand.