NCPA Supports Lawmakers' Call to Review Cuts in Diabetes Test Supply Reimbursement

Published Online: Wednesday, February 27, 2013
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Alexandria, Va. February 27, 2013 - The National Community Pharmacists Association (NCPA) today commended a bipartisan push for the Government Accountability Office (GAO) to review the impact on patients of sharp reductions in reimbursement for diabetes test supplies (DTS) provided by community pharmacies to Medicare beneficiaries.

Reimbursement for these products is scheduled to be reduced in April and then again July 1 when one national payment rate is adopted by the U.S. Centers for Medicare and Medicaid Services (CMS). The two cuts combined represent a 72 percent average decrease in reimbursement for retail pharmacies.

U.S. Reps. Diana DeGette (D-Colo.) and Ed Whitfield (R-Ky.)—have sent a letter to GAO urging it to study the effect of the cuts. The two leading lawmakers serve as co-chairs of the Congressional Diabetes Caucus, which is comprised of nearly 200 Representatives, and also on the House Energy and Commerce Committee.

"We are concerned about the impact of this reimbursement reduction, and what it will mean for beneficiaries' access to DTS and their ability to maintain their current brand of testing strips (and their corresponding glucose monitor)," they wrote. "We ask that you begin this study immediately as we believe that it is of the utmost importance to diabetes patients in America. We think it is incumbent upon us to make sure that the current quality of care is upheld."

Specifically, the Representatives asked GAO to examine the cuts' impact on the number of DTS suppliers; the quality of the DTS available to beneficiaries; the distance beneficiaries may need to travel in rural areas to obtain their supplies; patient adherence to their testing regimen; and the degree to which beneficiaries receive DTS via mail that they did not request or do not need.

Previous surveys of independent community pharmacists have found that 92 percent would be forced to stop offering DTS rather than accept below-cost reimbursement. Moreover, pharmacists often provide patients with face-to-face counseling on the proper use of these essential medical supplies. In addition, most independent community pharmacies currently offer same-day, home delivery. However, along with the drastic cuts that will be imposed on community pharmacies, they will also be prohibited beginning July 1, 2013 from providing home delivery of DTS to Medicare beneficiaries and to beneficiaries in Assisted Living Facilities (ALFs). Independent pharmacies, in particular, often serve rural or inner-city areas where patients may have limited access to other health care providers.

"NCPA fully supports and appreciates the efforts of these lawmakers on behalf of their constituents and the community pharmacists who serve them," said NCPA CEO B. Douglas Hoey, RPh, MBA. "They are rightly concerned about the well-being of patients in their districts. Round 1 of CMS' competitive bidding for DTS made two things clear. Patients' overwhelmingly prefer to use local health care providers for face-to-face service and that mail order auto-shipping is a source of both inconvenience to patients and wasteful spending for Medicare and taxpayers."

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