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GAO urged to review reimbursement cuts for diabetes supplies
February 28th, 2013
ALEXANDRIA, Va. – The National Community Pharmacists Association has applauded lawmakers' push for the Government Accountability Office (GAO) to review the impact of planned reductions in reimbursement for diabetes test supplies (DTS) provided to Medicare beneficiaries by community pharmacies.
NCPA said that Reps. Diana DeGette (D., Colo.) and Ed Whitfield (R., Ky.) on Wednesday sent a letter to the GAO urging it to study the effect of the reimbursement cuts. The two lawmakers are co-chairs of the Congressional Diabetes Caucus.
Reimbursement for DTS is slated to be reduced in April and then again July 1 when one national payment rate is adopted by the Centers for Medicare and Medicaid Services (CMS). Combined, the cuts represent a 72% average decrease in reimbursement for retail pharmacies, NCPA noted.
"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)," DeGette and Whitfield 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."
In the letter, the lawmakers asked the GAO to gauge the effect of the reimbursement reductions on the number of DTS suppliers, the quality of the DTS available to Medicare beneficiaries, the distance that beneficiaries may need to travel in rural areas to get their supplies, patient adherence to their testing regimen, and the degree to which beneficiaries receive DTS via mail that they didn't request or don't need.
"NCPA fully supports and appreciates the efforts of these lawmakers on behalf of their constituents and the community pharmacists who serve them," NCPA chief executive officer B. Douglas Hoey said in a statement. "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," Hoey explained. "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."
NCPA added that surveys of independent pharmacists have found that 92% would be forced to cease offering DTS because of below-cost reimbursements. Pharmacists, too, often provide in-person counseling on the proper use of these supplies. Most community pharmacies now offer same-day home delivery, but starting July 1 they will also be prohibited from providing home delivery of DTS to Medicare beneficiaries and to beneficiaries in assisted living facilities. The association pointed out that many independent pharmacies serve rural or inner-city areas where patients may have limited access to other health care providers.