- Condition Centers
June 20, 2013 (Alexandria, Va.) - With the July 1 scheduled implementation of Medicare's so-called "competitive bidding" and National Mail Order program for diabetes test supplies (DTS) fast approaching, the National Community Pharmacists Association (NCPA) is urging lawmakers to support H.R. 2375, recently introduced legislation that would delay the programs until a number of issues can be resolved. H.R. 2375, the Transparency and Accountability in Medicare Bidding Act, was introduced by U.S. Rep. Glenn "G.T." Thompson (R-Penn.) and Bruce Braley (D-Iowa), and is co-sponsored by Reps. Lou Barletta (R-Penn.), Bill Posey (R-Fla.), Tom Rooney (R-Fla.), Ileana Ros-Lehtinen (R-Fla.), and C.A. "Dutch" Ruppersberger (D-Md.).
"This legislation is in the best interests of patients, which is why NCPA enthusiastically supports its enactment," said NCPA CEO B. Douglas Hoey, RPh, MBA. "The National Mail Order program policies Medicare is implementing are penny-wise and pound-foolish because they run the significant risk of contributing to more hospitalizations and costly health care interventions for diabetes patients. In addition, by steering patients away from their longtime community pharmacist, Medicare's changes fly in the face of bipartisan efforts toward better coordinated care models, such as through medical homes and accountable care organizations."
The Centers for Medicare & Medicaid Services (CMS) is preparing to implement cuts that will collectively represent a 72 percent reduction this year in pharmacy reimbursement for diabetes testing supplies. Such unsustainable reductions may force some community pharmacies to stop offering DTS to seniors, which could create access concerns in underserved rural and inner-city areas. In addition, it will force some seniors to switch from higher-quality glucose meters to lower-end models.
Moreover, CMS is imposing a senseless ban on same-day, home deliveries by independent community pharmacists to homebound seniors and beneficiaries in assisted living facilities. Starting July 1, Medicare will pay the same amount whether patients access their diabetes testing supplies face-to-face from a local health care provider or through the mail, but the agency's new definition of "mail order" would prohibit community pharmacies from continuing to provide delivery services.
"Many seniors may experience some disruption as both the providers and the equipment to which they are accustomed may no longer be available to them," Hoey added. "Some beneficiaries have relied on their community pharmacy for decades. There's no justification for banning these trusted providers from furnishing this service to some of Medicare's frailest populations—beneficiaries who are homebound or in assisted living facilities—at no added cost to the government."
Recently 43 members of Congress led by U.S. Reps. Aaron Schock (R-Ill.) and Peter Welch (D-Vt.) wrote to Medicare to question the prohibition on such deliveries. The new policy "will cause disruption in the care provided to Medicare patients," the lawmakers wrote. "Now that retail and mail order suppliers receive the same level of reimbursements, we believe there is no further reason to prohibit home delivery by retail pharmacies. We ask that you expeditiously consider allowing small retail pharmacies to continue home delivery and not prevent these crucial face-to-face counseling and adherence services from being available to Medicare patients."