‘We will continue to talk to Congress,’ diabetes group says

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Tuesday, November 20, 2018

YARMOUTH, Maine – Medicare’s mail-order program for diabetes testing supplies has decimated the industry, shutting out suppliers and drastically cutting reimbursement.

When mail-order contracts go away come Jan. 1, access could get dicey for patients, says Christel Aprigliano, CEO of the Diabetes Patient Advocacy Coalition.

“There is no obligation for these suppliers to provide mail-order supplies and that greatly concerns the diabetes community,” she said. “Not having (supplies) is not an option.”

HME News: CMS has made changes to how products will be bid in future rounds of competitive bidding. How will those changes impact the mail-order program, if at all?

Christel Aprigliano: The whole idea of the maximum winning bids and lead item pricing—I just don’t see how that’s going to work for diabetes testing supplies. (The benefit) has already been destroyed. I can’t see how this is going to help patients. 

HME: Do you think this will create further access issues for patients?

Aprigliano: The suppliers were already barely supplying the trusted supplies that are offered to our community. I can’t see how they will continue to offer those services. Any smart businessperson will look at DTS and what Medicare is paying suppliers and see it’s not a smart solution for them. We’re going to closely monitor this. We will continue to take action, continue to comment, and continue to talk to Congress about what needs to be done to ensure the diabetes community continues to get access to these testing supplies.

HME: Putting aside the competitive bidding program, there have been a lot of changes in the diabetes supply market, including new technology and the advent of subscription services. Thoughts?

Aprigliano: I applaud the disruptors in the industry. Part of the reason why these subscription services have started is because the traditional models of insurance design are failing people with diabetes or chronic conditions in general. Even with co-insurance or copays, it can be less expensive to use these services.

HME: You can’t talk about diabetes these days without talking about the skyrocketing cost of insulin. Will we ever see relief there?

Aprigliano: I firmly believe that it will require legislation on the federal level to ensure that every person who needs insulin has access to affordable insulin, and that’s insulin analogs, not the human insulin you can purchase at Walmart. I do know that manufacturers aren’t deaf. They hear the cries from the patient community and they are trying to provide safety net programs but we find them too restrictive and almost Byzantine in trying to get access. hME