Medicare

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Monday, December 31, 2001

WASHINGTON - Suppliers of diabetic shoes are predicting their sales could increase significantly in the wake of a decision by the Center for Medicare and Medicaid Services (CMS) to expand foot care coverage for some beneficiaries with diabetes.

CMS announced recently that beneficiaries suffering from diabetic peripheral neuropathy with loss of protective sensation (LOPS) may now receive two foot exams per year, providing they haven't seen a foot care professional for some other reason. Medicare typically excludes coverage for routine foot care, except under specific circumstances.

The impetus for the change?

Studies link diabetic peripheral neuropathy with increased risk of foot ulcers and amputations, and regular foot care can help avoid these kinds of injuries and infections, CMS says. Because beneficiaries with this condition lack the ability to feel pain, they are not alerted to potentially dangerous injury.

CMS has not announced when the new coverage policy will go into effect.

Nathan Gabhart, store manager for William Bros Healthcare Pharmacy in Princeton, Ind., said more than half of the beneficiaries that visit his store for foot care have diabetic peripheral neuropathy. He predicts sales for suppliers of diabetic shoes could increase as much as 30%.

"The more times a beneficiary sees a doctor, the more referrals we'll potentially get," Gabhart said. "I think this'll have a dramatic impact."

Suppliers say the increase in sales hinges on the idea that with more examinations, doctors will diagnose beneficiaries with diabetic peripheral neuropathy sooner, and they'll send beneficiaries to suppliers to prevent injuries with products like diabetic shoes with special inserts.

"If suppliers promote their products and work with referral sources, I think this could have a big impact on sales," said Dick Upham, president of Medical Supplies in Waterville, Maine.

But if foot care professionals decide to fit beneficiaries themselves, that increase won't likely come to fruition, suppliers say.

Regardless, Stephen O'Hare, president of Pedors Shoes in Marietta, Ga., said CMS's expansion of foot care coverage is a good start in raising awareness of diabetes and the importance of having feet checked regularly. He tips his hat to the new administration at CMS.

"I think they're really trying to get into the nitty gritty of what's needed over there," he said.

Eventually, O'Hare said he'd like to see foot care for beneficiaries with diabetes and/or who are overweight become as commonplace as mammograms for women over 40 years old.

CMS reviewed its existing policy on diabetic peripheral neuropathy at the request of the American Diabetes Association and decided to approve the expanded coverage after reviewing scientific data. HME

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