AAH offers mail-order ideas

Sunday, November 30, 2008

WASHINGTON--CMS needs to ensure a level playing field if it rolls out national competitive bidding again for mail-order diabetes supplies, AAHomecare told the agency in a letter in early October.

“We are trying to work with Medicare to help them understand the various markets subject to NCB,” said Walt Gorski, vice president of government affairs for AAHomecare. “We want to make sure that all suppliers have the same ability to service the beneficiaries.”

Mail order diabetes products took a 43% cut, on average, in Round 1 of competitive bidding. Missing from the list of winning bidders were well-known national mail order companies, raising concerns about patient access and quality of care.

“So many of the bids were so off-the-mark that companies could not have stayed in business with that pricing,” said Tim Cady, president of Carlsbad, Calif.-based Advanced Diabetes Supply, which did not win a bid.

To keep that from happening again, the Medicare Improvements for Patients and Providers Act (MIPPA) requires providers who bid on diabetic testing supplies to offer brands with at least 50% market share.

That market share data should not include the retail market or younger patients, says AAHomecare. The association asked that “CMS conduct a confidential survey to gather accurate mail-order market share data for the Medicare-aged population and ask all companies to identify brands and products provided by mail order.”

The association also recommended that mail-order diabetes centers adhere to national call center standards, including hours of operation; compliance with federal telemarketing regulations; multi-language or translation capabilities; customer service training; and a multi-channel approach for supply reorders.

Ensuring patient access to products and services ultimately saves the healthcare system money, says Gorski.

“If diabetes is one of the leading medical conditions in the country, Medicare should be doing everything it can to ensure that beneficiaries are able to manage these conditions,” he said. “Any barrier they put up inadvertently will lead to higher healthcare costs if compliance is not maintained.”