Diabetes draft yanked

Thursday, December 16, 2010

BALTIMORE - Looks like CMS will leave the diabetes benefit alone after all.

The Jurisdiction B DME MAC announced Dec. 14 that the DME MACS have rescinded a proposed change to the glucose monitors local coverage determination (LCD).

"We're very pleased," said Walt Gorski, vice president of government relations for AAHomecare.

 A draft LCD, released Sept. 23, contained a number of changes, including: increased documentation for refills of strips and lancets; limits on the number of testing supplies allowed; and additional criteria for beneficiaries to meet, including more frequent contact with the physician's office.

Diabetes is not a one-size fits all disease, stakeholders argued.

"Individual diabetic patients have unique health factors that influence how often they need to test their blood sugar," said John Norton, associate director of public relations for the National Community Pharmacists Association. "Providers and suppliers should have the flexibility to provide the quantity of testing products that each individual patient needs."

A public meeting in October drew a wide variety of diabetes stakeholders, including HME providers, manufacturers and physicians, who spoke out against the changes.

"It is incumbent upon us to work not only with the supplier community but with the clinical community to ensure proper access to diabetes supplies," said Gorski. "Diabetes is our most pervasive condition and we shouldn't be pennywise and pound foolish. We will continue to make arguments on a clinical basis that supports the need for testing based on physicians' medical judgment."