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'Anti-Switching Provision' in Competetive Bid Program

By Diane Harbaugh posted 07-24-2012 09:36

  

Competitive Bidding started as a national competition for mail order items to help improve processes, eliminate fraud and streamline the order process for those using CMS services.  As many know, the road has definately been rocky, with revisions and corrections of the program, and it is considered a great program by some and an enormous financial debacle by others. 

Shortly after it was intitiated, CMS found that some of the suppliers were substituting blood glucose meters and other durable medical equipment included in the Competetive Bid program for products that allowed for a better margin for the supplier.  As a response, CMS reviewed the Competetive Bid Act, and revised the Act in November 2011 to include the following:

"Federal Regulations inlcude an "anti-switching" provision as a term of the contract for suppliers under the national mail-order competition for diabetic supplies. This regulation prohibits contract suppliers from influencing or incentivizing beneficiaries to switch their current glucose monitor and testing supplies brand to another brand.  The anti-switching rule requires  contract suppliers to furnish the brand of testing supplies that work with the monitor currently used by the beneficiary.  This rule was established to protect beneficiary and physician choice of gucose monitors.  If a contract suplier does not carry the brand the beneficiary has been using, it can inform the beneficiary that it does not carry that brand.  The beneficiary may then engage the contract supplier about alternative brands and the supplier can describe what brands it offers; however, the supplier cannot be the one to initiate this conversation.   It is important to know that suppliers can frunish alternative brands of glucose monitors at little or no cost to a beneficiary who decides to switch to an alternative brand.   Manufacturer rebates and trrade-in promotions have been widespread for several decades and have significantly reduced or, in most cases, entirely eliminated the cost of switching from one glucose monitor brand to another." 

A challenge in this revision is that when told that their monitor brand is not carried by that supplier, the beneficiary is left with little recourse other than to switch to another brand monitor.  The question then presented is - Why do suppliers have to carry any brand but the one they want everyone to switch to?  While one could argue that choice is provided to the beneficiary, it appears to be a manipulated choice. 

As a diabetes educator, I do see the impact of Competitive Bid on my patients.  Do you? 

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09-06-2012 13:45

Competitive Bid / Meter Brands / Medicare Payment Adjustments for Non-Mail Order SMBG Supplies

INFORMATION THAT MIGHT BE OF INTEREST (AND HOW TO ACCESS IT ONLINE):


LISTING OF METERS THAT MEDICARE-CONTRACTED SUPPLIERS PROVIDE


   In Medicare's online Supplier Directory, the brands of meters carried by the Medicare-contracted DME suppliers are specified.  Note Medicare's disclaimer: information is provided by the supplier, and Medicare does not edit it in any way.  To get to this information, start here: www.medicare.gov/Supplier/Home.asp, and then start making selections to get to the table of information.  If you are affected by the competitive bid process, where asked to select a category of products, be sure to select "Mail Order Diabetic Supplies" (has a gold star by it) not "Blood Glucose Monitors & Supplies: Mail Order".


   It is unfortunate that individuals with Medicare are not allowed to take advantage of discount programs offered by meter manufacturers with well-established track records.


 


WATCH FOR NON-MAIL-ORDER SMBG SUPPLIES TO BE AFFECTED


There is information about CMS's initiative regarding adjusting Medicare payment amounts for non-mail-order diabetes testing supplies at: www.cms.gov/apps/events/event.asp?id=662&Kw=&Mh=NoMonth&cboOrder=date&Yr=NoYear&type=2.  If that long URL doesn't survive copying and pasting, you can go to www.cms.gov/apps/events, choose "Past Events", and either enter a search term or scroll down to 7/23/2012 to find the event entitled, "Public Meeting Regarding Inherent Reasonableness of Medicare Fee Schedule Amounts for Non-mail Order (Retail) Diabetic Testing Supplies".  The slide presentation (free download) is worth the read, at least for terminology if not overall awareness of the initiative.


 

07-26-2012 11:14

Competitive Bidding / Switching meters

This very topic came up in my class yesterday.  After each commercial my blood just boils, because who will the consumer / pt listen to, the educator or the nice grandmotherly lady on the TV late at night?  I've had nursing staff approach me looking for the meter that doesn't hurt.  During class, this subject took about 15 mins to discuss with the class members.  At the end they really seemed to have a good understanding, but would like to have that 15 mins for other questions they might have.  Can just be very frustrating. Now taking it the next step, how can we advocate and protect our patients.  Hope to see more discussion.

07-26-2012 10:07

Competitive Bid Program

Working in rural areas of PA, I often have patients come to me with 3-4 different meters because "the company didn't have my meter so they sent me a new one". This compromises accuracy & frustrates the pt learning a new meter. The advertising by these suppliers is outrageous in the media - patients are always asking for the meter " you don't have to prick your finger". Leads the patient to call them for another meter!

07-26-2012 07:48

competite Bid program

I have seem a multitude of patients who come to me because they are being switched and now need to learn how to obtain their new supplies and learn a new meter. It is very time consuming and some patients stop testing all together because they are not willing to learn a new meter after just getting used to the one they initially chose.