Mail-order program creates 'vicious cycle'
CHICAGO – Many national mail-order contract suppliers aren’t carrying the diabetes testing supplies beneficiaries get prescribed, says the American Association of Diabetes Educators (AADE).
A recent phone survey conducted by the association found that none of the contract suppliers offer products with more than 50% market share, as required by the program, and only three of the suppliers carry all of the brands that they told CMS they would.
“Our educators are concerned because they’ve been told if they prescribe a certain meter the patient will get it and they are not,” said Martha Rinker, chief advocacy officer for the AADE. “They get sent an off-market meter that, frankly, doesn’t fit their needs.”
The association found similar problems in a 2011 survey in the Round 1 bid areas, and Rinker says they are seeing the same “vicious cycle” of patients getting shipments of testing supplies for meters that they aren’t using.
When patients don’t get what they were prescribed, it’s not uncommon for them to stop testing, she said.
“They’ll just throw up their hands and say, ‘I don’t need to do this,’” said Rinker. “Three or six months later, they’ll get back to the doctor and their (blood sugar averages) are through the roof.”
Between CMS paying for supplies that go unused, and the possibility of higher healthcare costs down the road due to complications like renal failure, the bidding program is not saving money.
“You save money on the front end, but it’s costing on the back end,” said Rinker.
The AADE recommends that CMS improve the information it provides to beneficiaries, including regular updates to Medicare.gov to ensure it accurately reflects participating suppliers and their available products; require suppliers to provide the same brands that their bids were based on in future rounds of competitive bidding; and regularly audit contract suppliers.