Does mail-order program meet requirement?

Tuesday, June 17, 2014

WASHINGTON – CMS may want to consider whether subsequent rounds of its national mail-order program for diabetes supplies meet a 50% requirement outlined in the Medicare Improvements for Patients and Providers Act (MIPPA). A new report from the Office of Inspector General (OIG) says 22 suppliers submitted at least 43 types of test strips for the three-month period from July to September 2013. Two types of test strips accounted for about 45% of the Medicare mail-order market share, three types accounted for 59% and 10 types accounted for 90%. The 50% requirement prohibits CMS from awarding competitive bidding contracts for diabetes supplies to suppliers that don’t demonstrate that their bid covers at least 50%, by volume, of all types of test strips. The OIG’s report is based on a sample of 1,210 claims drawn from a population of about 505,000 claims for test strips provided to beneficiaries during this period.