Big Win for Diabetes Medicare Beneficiaries & Thank You!
On February 9, 2018, the President signed the Bipartisan Budget Act of 2018, which included a big win for our diabetes Medicare community who receive their diabetes testing supplies through the National Mail Order supply program. Language from the Protecting Access to Diabetes Supplies Act of 2017 (H.R. 3271/S. 1914) was included, strengthening the rules surrounding the distribution of testing supplies to those on Medicare.The Protecting Access to Diabetes Supplies Act was introduced this summer. DPAC provided expert testimony on Capitol Hill about this issue and asked our community to contact their representatives in Congress to cosponsor this bill. It was the hard work of advocates throughout the community and the tireless efforts of Congressman Tom Reed's and Congresswoman Diana Degette's offices that helped to bring this into law.The two main functions of the language from the Protecting Access to Diabetes Supplies Act are the 50% Switching Rule and Anti-Swiching Rule.For people with diabetes on Medicare, the option to receive their testing supplies by mail order is convenient and cost-effective. However, in the past, they were often sent meters and strips that were not their trusted brand, which caused some beneficiaries to give up testing their blood glucose levels. If they attempted to get their supplies at a local pharmacy, they often found that the automatic shipments (without their knowledge or permission) prevented them from getting reimbursed for their purchases.
50% Rule
Suppliers bid to get contracts with Medicare, so it was to their advantage to get the cheapest testing supplies available on the market, which has been shown through studies to not always meet FDA accuracy standards. These were not the meters and strips that our diabetes Medicare community were trained to use.
With the 50% rule now in place, after January 1, 2019 all suppliers must make available at least 50% of all types of diabetes testing supplies on the U.S. market. This means better choices and trusted meters will now be available for mail order customers.
Anti-Switching Rule
As mentioned above, many diabetes Medicare beneficiaries received meters that they didn't want, but felt pressured to use or told there were no other options. The anti-switching provision requires all suppliers to give the meters and test strips they were prescribed by their medical professional and prevents suppliers from influencing or giving incentives to switch. Suppliers must also contact the beneficiary before they ship out supplies and must accept returned supplies if they were sent without confirmation.
Advocacy For The Win
It took the efforts of many organizations to raise this issue to Congress. The American Association of Diabetes Educators completed several secret shopper surveys to show that trusted meters weren't being supplied. The National Minority Quality Forum published studies showing the the Competitive Bidding Program for Diabetes Testing Supplies caused access issues and increased mortality rates for those in some areas. Many advocates in our own DPAC community called, tweeted, and spoke to their representatives to ask for these rules.