Diabetes providers take hit

Thursday, July 31, 2008

LAKE MARY, Fla.--Blue Cross and Blue Shield of Florida (BCBSF) wasted no time in lowering its reimbursement for diabetes supplies following Medicare’s new lower fee schedule for competitive bidding.

For many of the products, BCBSF now pays less than Medicare.

“It’s one of the consequences of competitive bidding that CMS doesn’t give a damn about,” said Barry Buchard, vice president of Crescent City-based Diabetes Home Care. “The bottom line is, we won’t be serving BCBSF diabetes patients any more.”

Under competitive bidding, mail order diabetes reimbursement in the Miami and Orlando competitive bidding areas took cuts of 41% and 42% respectively. The Medicare payment for test strips in Miami, for example, is $22.16. BCBSF’s price: $21.05.

Profit has become a dirty word, said Joan Cross, director of operations for Bradenton-based C&C Homecare. She no longer does diabetes.

“With prices that are below or equal to what we have to pay, what are you going to do?” she asked. “Who do they think is going to do it?”

BCBSF has asked providers that opt out of serving its diabetes patients to refer them to its new diabetic supply network, comprised of several large mail order firms, including Liberty Medical and Byram.

Provider Doug Wedekind, vice president and general manager of Deland-based Orange Belt Pharmacy, hasn’t decided yet whether or not to keep his BCBSF contract.

“We don’t want to hurt the patients,” he said. “We can’t just abandon them.”