The Medicare system can be a whole new world for people with diabetes. Lots of changes, but some things should not change: the blood glucose meter that your medical professional recommends to you and one that you know how to use – and trust.

The CEO of DPAC, Christel Marchand Aprigliano, gave expert testimony on Capitol Hill on July 20th, 2017 in support of bill H.R.3271, helping to protect access to accurate meters for people on Medicare using the National Mail Order program. (You can read the written statement from DPAC on this issue submitted for the record here.)

H.R.3271, “To amend title XVIII of the Social Security Act in order to strengthen rules in case of competition for diabetic testing strips, and for other purposes.” would strengthen various safeguards already in the CBP, including the 50 Percent Rule and the Anti-switching Rule.

What is the Competitive Bidding Program?

In 2003, Congress initiated a program that been beneficial for some therapeutic and medical areas, but disastrous for diabetes testing supplies. The Diabetes Patient Advocacy Coalition (DPAC) is asking Congress to fix this program and pass bill H.R.3271 to modify the most debilitating components affecting patients with diabetes.

Under the Competitive Bidding Program (CBP) for Durable Medical Equipment and Supplies, Medicare has paid increasingly less for medical supplies, including Diabetes Testing Supplies (DTS), like glucose test strips and lancets. Although Congress implemented this program to save money and decrease fraud, the CBP has considerably limited beneficiaries with diabetes in their access to diabetes testing supplies. Under the CBP, the most common blood glucose testing systems are now unavailable through mail order to beneficiaries with Medicare.

Patients unable to receive their trusted glucose meters have stopped or severely decreased blood sugar testing, while continuing to administer themselves insulin. Mortality, inpatient admissions, and inpatient costs have increased among the patients affected by this decreased ability in blood testing.

To compound this issue of access, the Diabetes Technology Society recently conducted a study revealing that an alarming 12 of 18 testing systems available to Medicare patients provide inaccurate results. This means that even if patients do get one of the limited testing systems under the CBP, the DTS may still endanger their lives and ability to manage diabetes.

 

What Needs To Change?

fix it buttonThrough focusing on issues of safety, quality, and access, the Diabetes Patient Advocacy Coalition champions public policy initiatives to improve the health of people with diabetes. The current state of the Competitive Bidding Program and National Mail Order program creates glaring problems in each area.

Under H.R. 3271, two beneficiary protections would be strengthened:

  • The 50 Percent Rule directly addresses the question of access to DTS. Under the 50 Percent Rule, Congress determined that insurance companies must make 50 percent of all DTS supplies available to beneficiaries before requiring mail order, continuing to allow beneficiaries to have access to DTS they used before the CBP. The Center for Medicare and Medicaid Services (CMS) did not implement this effectively, as the “50 percent of supplies” was only applied to DTS in a supplier’s bid. Additionally, one tenth of the 50 percent of DTS varieties available could fall into a catch-all “other” category – a loop hole meaning that suppliers could essentially make even less inventory available to beneficiaries. Strengthening the 50 Percent Rule would eliminate the “other” category and increase monitoring of suppliers, among other protections.
  • The Anti-switching Rule was established to ensure that physicians and beneficiaries maintained access to preferred testing meters. However, this rule is a low hurdle for the CMS and NMO to hop over, as both have made it increasingly difficult to purchase supplies from other suppliers or switch out of NMO. H.R.3271 would strengthen the Anti-switching Rule by changing the refill process to give the beneficiary more choice and knowledge from the supplier, and through codifying this rule.

 

With these strengthening measures in place, DPAC firmly believes that the access, safety, and quality of patients will dramatically increase under H.R.3271. Through permanently patching the holes in the CBP, this bill helps to decrease the painful and costly long-term effects associated with diabetes and inadequate blood glucose monitoring.

Use the DPAC platform to contact your representatives and ask them to support H.R.3271. If the CBP is not improved, lives hang in balance as safety, quality, and access to diabetes supplies remain ignored.

Click on the image below or the link above to take action.

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