Centers for Medicare and Medicaid Services (CMS) and Competitive Bidding
The National Minority Quality Forum issued a report at the American Diabetes Association 75th Annual Scientific Sessions in 2015 – National Minority Quality Forum Report on CMS Competitive Bidding Program. The Forum detailed the results of a competitive bidding program (CBP), implemented by the Centers for Medicare and Medicaid Services (CMS) in nine test markets in 2011. Competitive bidding affects retail channels, which see significant reductions in reimbursements for diabetes testing supplies. As a result, pharmacies (especially independent ones) have less incentive to sell BGM supplies to people on Medicare.
Some Medicare patients have to pay out of pocket if they want to keep using the BGM prescribed by their doctor. In 2011, the CBP disrupted access to necessary blood glucose monitoring supplies, and correlated to more hospitalizations and deaths in these nine test markets. The CBP went national in 2013. Here is the NMQF Press Release that accompanied their original report NMQF Report Press Release_12 01 2015.
The DLC’s Stance
Effective diabetes management requires that therapy be personalized to the unique needs of each patient. The CBP has not only disrupted beneficiary access to the tools they need to manage their diabetes but has violated the sacrosanct relationship between physicians and their patients.
Given these troubling findings that show the suffering of Medicare beneficiaries, it is our position that CMS be compelled to suspend the CBP until adequate safeguards are in place to monitor the true impact of the program, preserve the integrity of physician-patient relationships, and protect beneficiaries from potential further harm.
We’ve taken a strong position on the “unintended consequences” of the CMS’s Competitive Bidding Program, and will continue to monitor its effects. Here are highlights of our actions to date on this important issue for seniors with diabetes:
- Our original press release on this issue in 2015 was recently published in the April 2016 edition of Diabetes Care New Data Show CMS Competitive Bidding Program Coincided with Increased Hospitalizations and Death Among Medicare Beneficiaries with Diabetes.
- In March 2016, we sent a letter to the Acting Administrator of CMS asking for a suspension of the program DLC Letter to CMS 3 17 16.
- CMS’s response to the reports was to restate the success of the CBP and deny any issue exists. Accordingly, in June 2016, we sent letters to key leaders of Congress and the GAO asking for their assistance:
- Letter to Representative Kevin Brady, Chair – House Ways and Means Ctte: Brady – DLC Letter to Congress
- Letter to Senator Orrin Hatch, Chair – Senate Finance Ctte: Hatch – DLC Letter to Congress
- Letter to Senator Mitch McConnell – Senate Majority Leader: McConnell-DLC-Letter-to-Congress
- Letter to Representative Frank Pallone – Ranking Democrat House Energy and Commerce Ctte: Pallone – DLC Letter to Congress
- Letter to Representative Nancy Pelosi – House Minority Leader: Pelosi – DLC Letter to Congress
- Letter to Senator Harry Reid – Senate Minority Leader: Reid – DLC Letter to Congress
- Letter to Representative Paul Ryan – Speaker of the House: Ryan – DLC Letter to Congress
- Letter to Senator Ron Wyden – Chair – Senate Finance Ctte: Wyden – DLC Letter to Congress
- Letter to the Government Accountability Office: DLC Letter to GAO_10.28.2016