The American Association of Diabetes Educators issued a statement of support following an early Friday morning congressional budget deal that includes several changes to Medicare’s Competitive Bidding Program, among them a strengthening of the so-called 50% and anti-switching rules that affect patient access to diabetes testing supplies.
The fiscal bill, which followed a brief, overnight government shutdown, included language from the Protecting Access to Diabetes Supplies Act, designed to strengthen protections for Medicare beneficiaries who buy blood glucose testing supplies through the National Mail Order Competitive Bidding Program (CBP). The new language strengthens enforcement of current law requirements that suppliers in the CBP include at least 50% of the types of test systems that were on the market before the CBP’s implementation. The changes also bolster consumer protections that prohibit suppliers from encouraging beneficiaries to switch from one testing system to another.
“These two changes help ensure that people with diabetes can get and maintain access to the blood glucose monitoring supplies to which they have become accustomed,” Kurt Anderson, AADE director of state and federal advocacy, told Endocrine Today. “This legislation doesn’t fix the entire system, but [the changes] are a good step in the right direction.”
Since the CMS implemented the CBP for diabetes testing supplies purchased through mail-order suppliers in January 2011, several reports have noted that product choices are limited through the program, likely influencing patient health outcomes.
In an analysis by the National Minority Quality Forum released in March 2016, researchers assessing Medicare claims data from 2009 to 2012 found that the CBP disrupted beneficiaries’ ability to access diabetes testing equipment, leading to an increase in mortality, hospitalization rates and inpatient costs. In three “secret shopper” surveys in 2011, 2013 and 2017, AADE diabetes educators contacted contract suppliers authorized to sell diabetes testing supplies to Medicare beneficiaries through mail order. The participants found that CBP suppliers did not make available all products that were listed on the Medicare.gov Suppliers Directory. In addition, survey results revealed that many products available to beneficiaries before the implementation of round 1 of the program were no longer available through mail-order suppliers.
“At the inception of this program, our members noticed that there were issues which negatively impacted people with diabetes,” Anderson said. “One of the most egregious issues included blood glucose monitoring strips. Many were being switched to an unfamiliar brand because the vendor did not carry that particular brand of strip. This unfamiliarity often led to people giving up on checking their blood glucose and some dying as a result. AADE was at the forefront of exposing these issues by surveying the contractors in this program.”
In the AADE statement, the organization called the legislation a “big win for people in the diabetes community.”
“AADE applauds Congress and specifically Congressman Tom Reed (R-New York) and Congresswoman Diana DeGette (D-Colorado) for advocating for this bill that will not only help fix a broken system, but put the lives of people with diabetes first,” Anderson said in a press release. “Our surveys show that the CMS CBP put beneficiaries at unnecessary risk through forced switching of diabetes supplies to unfamiliar or unsuitable products.” – by Regina Schaffer
Disclosures: Anderson is director of federal and state advocacy for AADE. The National Minority Quality Forum, a nonprofit organization, received support for the 2016 study from Abbott, Acelity LP Inc., Lifescan, Roche Diabetes Care, US Healthcare Supply LLC and US MED.