Group seeks exclusion for diabetes supplies

Tuesday, October 31, 2006

ALEXANDRIA, Va. - As the clock ticks toward final rules for competitive bidding, industry members continue to press their case for exempting diabetes supplies.
The Diabetes Access to Care Coalition (DACC), the National Community Pharmacists Association (NCPA) and diabetes product manufacturers met with CMS officials and several high-ranking lawmakers in recent weeks, trying to convince them that NCB would limit patient access to diabetic supplies.
"We think diabetes is different in terms of the cost to the health-care system and the cost to the Medicare program with over a quarter of beneficiaries having diabetes," said Mark Weller, a senior vice president at B&D Consulting, which manages the coalition. "Patients that use diabetes supplies rely on those for up-to-the-minute diagnostic information in treating and managing the disease."
The coalition believes that, as the NCB proposal stands now, with its accreditation requirements and possible mandatory mail-order provision, patient access to such products would be sharply curtailed.
CMS estimates 90% of Part B providers--of which pharmacies comprise the largest portion--would participate in competitive bidding, but a recent NCPA survey revealed that only 31% of community pharmacists plan to do so. (See HME News, Aug. 2006).
John Keegan, owner of Heights Terrace Pharmacy and Diabetes Shoppe in Hazelton, Pa, has several hundred Medicare diabetes patients. He doesn't know if he'll bid.
"I don't have the resources to do it," said Keegan.
Steve Nelson, CEO and president of Okeechobee Discount Drugs in Okeechobee, Fla., said even large companies that participate in NCB will have trouble with demand.
"How can Liberty Medical or Lincare take care of the whole entire west coast of Florida?" said Nelson. "They can't."
Keegan agrees it would be nearly impossible for any provider to provide the level of personal service that patients currently enjoy.
"I supplied a talking meter to a patient," said Keegan. "I personally had to go to the home and help her use her hands to train her. It was tough for me, it will be tougher for the provider that wins."
Tony Lee, director of public policy at NCPA, expects to see an increase in Part A emergency costs associated with the resulting decline in health.
"Diabetes is already an under-treated disease," said Lee. "If you do have long distances, some seniors will not be able to diligently monitor their own diabetes."
Ultimately, it is the consumer who is forgotten, said Nelson.
"Congress thinks they are going to save all this money," said Nelson. "But there is a price that has to be paid for good quality healthcare."