Language in the new government budget ensures effective changes to CMS' Competitive Bidding Program for diabetes testing supplies that will benefit patients with diabetes.
The diabetes community has reached a major milestone after language from the Protecting Access to Diabetes Supplies Act was included in the FY2018 and FY2019 budget deal.
According to the American Association of Diabetes Educators, a multi-disciplinary professional membership organization dedicated to improving diabetes care through innovative education, management and support, the language in the budget deal ensures effective changes to CMS' Competitive Bidding Program (CBP) for diabetes testing supplies (DTS). The adopted language in the budget will make effective changes to the CBP that include strengthening the 50% and anti-switching rules.
AADE Director of Advocacy Kurt 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.”
The organization released surveys in 2011, 2013, and 2017 that showed the current program reduced beneficiary choice and access to commonly used DTS. Another report—the 2016 National Minority Quality Forum—found that reduced access to DTS had a direct link to an increase in mortality and complications, inpatient admission and supplier costs.
The “50 Percent Rule” was implemented by Congress to ensure beneficiaries continue to have access to the same test systems used before the CBP is enacted. Mail-order suppliers are required to make available at least 50% of all types of available DTS before the CBP is implemented.
Previously, an awarded contract could waive suppliers from being required to provide 50% of DTS simply by selecting “Other — Not Listed.” With the new bill, CMS is unable to provide an additional percentage credit to satisfy the 50% rule. In addition, CMS must also use other sources of data other than Medicare to measure consumption and utilization of DTS.
The anti-switching rule will protect beneficiary and physician choice of glucose meters. Suppliers must respect the test of choice decided on by the patient and physician and not influence beneficiaries to switch their current glucose monitor and testing supplies brand to another brand.
Suppliers are also required to provide beneficiaries with an explanation of the beneficiary’s rights to receive DTS compatible with their blood glucose testing system, the right not to be influenced or incentivized to switch blood glucose testing systems, the right to obtain strips from another mail order supplier or retail pharmacy, and the right to reject unwanted DTS.
“AADE applauds Congress and specifically Congressman Tom Reed and Congresswoman Diana DeGette 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.