As medical professionals we, the in the diabetes world, are familiar with Competitive Bid and articles have certainly abounded on this subject. Recently in the HME news (a free publication that keeps the durable medical equipment world in touch with current issues at www.hmenews.com ) there was an article by T. Flaherty, the managing editor, on the topic of diabetes and supplies titled "Bottom drops out of diabetes".
In this article, a quote by an owner of a Diabetic Supply company stated "It really appears there is not any value placed on diabetes patients or the prevention of complications. I cannot see how quality product or service or choice will be provided once this (CB) is implemented". Since payment for diabetes supplies is 72% lower than the fee schedule, the providers are wondering how the payment amounts have decreased from Round 1! With the most current payment amount a box of 50 strips will be reimbursed at $10.41.
The bidders were required to offer meter brands that have at least 50% of the market share. But at the rate of reimbursement, it won't happen. Suppliers also have 'value brands' and use these too but their cost (identified by one distributor) is $6.00 before adding their shipping costs. CMS states they have 15 mail order contracts. There are approximately 10 million Medicare beneficiaries with diabetes and a 'guess'timated 60%' who use mail order. Doing the math, this means that if each contract had an equal number of patients, it would mean each would have 400,000.
The irony in all of this is statements from CMS that they have received 'very few complaints' which leads me to wonder, how many know about it? In speaking with patients and those who are Medicare eligible - none to date were aware of this battle that is even happening! Many of calls are from people requesting training on a meter they obtained 'through the mail' from their new distributor. I remind them that it is their right to request their meter of choice but that if their current distributor doesn't carry that meter, they will either have to switch meters or companies. Most of the patients I speak with don't want to have to call several distributors to find one providing their meter of choice and simply accept the meter they are given.
How can we, as educators, inform our patients that there is a 'no switch rule', that CMS has instituted Competitive Bidding, that their product is decided based on cost to distributor not necessarily qualtiy of product? Has anyone found a good way to inform their clients?