OIG: Handful of strips dominated Medicare mail-order market

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Wednesday, January 16, 2019

WASHINGTON – The top two strips accounted for 53% of the Medicare mail-order market, and the top 10 strips accounted for 98% of the market, according to a new report from the Office of Inspector General.

Overall, suppliers in Medicare’s national mail-order program provided 17 types of test strips during the three-month period between April 1, 2018, and June 30, 2018, the OIG found.

To conduct the report, the OIG sampled 1,210 claims from a population of 313,704 claims.

Suppliers must comply with a rule outlined in the Medicare Improvements for Patients and Providers Act (MIPPA) requiring them to provide at least 50% (by volume) of the types of test strips provided to beneficiaries.

The budget for the Department of Health and Human Services for fiscal year 2019 included a provision that would strengthen the 50% rule by requiring bidders to attest to their ability to maintain an inventory of strips consistent with their bid, and requiring CMS to establish and maintain a surveillance program to ensure suppliers are complying with the rule.

All competitive bidding contracts expired Dec. 31, 2018.